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Organization

DAYAKER R. GAGADAM M.D.PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DAYAKER RAO GAGADAM M.D., (PRESIDENT)
(817) 293-3000
Entity
Organization

Contact information

Practice address
11803 SOUTH FWY, SUITE 208, BURLESON, TX 76028-7012
(817) 293-3000
(817) 293-3291
Mailing address
11803 SOUTH FWY, SUITE 208, BURLESON, TX 76028-7012
(817) 293-3000
(817) 293-3291

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
K3195
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
122066703
TX
Enumeration date
07/25/2011
Last updated
07/25/2011
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