Individual
GAUTAM ATUL AGRAWAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2825 OAK LAWN AVE UNIT 192749, DALLAS, TX 75219-4688
(844) 389-5711
(877) 880-2039
Mailing address
2825 OAK LAWN AVE UNIT 192749, DALLAS, TX 75219-4688
(844) 389-5711
(877) 880-2039
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
66308
CT
2085R0202X
Diagnostic Radiology Physician
Primary
A90996
CA
2085R0202X
Diagnostic Radiology Physician
R8853
TX
Other
Enumeration date
10/23/2006
Last updated
09/10/2024
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