Organization
INTERNAL MEDICINE ASSOCIATES OF SOUTH DALLAS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ASHWANI DAYAL SRIVASTAVA MD (PRESIDENT)
(214) 697-7985
Entity
Organization
Contact information
Practice address
4305 W WHEATLAND RD, SUITE NUMBER 101, DALLAS, TX 75237-3303
(214) 697-7985
(972) 708-9498
Mailing address
4305 W WHEATLAND RD, SUITE NUMBER 101, DALLAS, TX 75237-3303
(214) 697-7985
(972) 708-9498
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
L3488
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0047QW
BCBS
TX
01
—
1467507038
INDIVIDUAL NPI NUMBER
—
05
—
150972102
—
TX
05
—
191673601
—
TX
Enumeration date
10/02/2007
Last updated
10/28/2014
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