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Individual

DR. SUBRATA KRISHNA TALUKDAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
12446 WEST AVE STE 200, SAN ANTONIO, TX 78216-2530
(210) 386-5400
(210) 525-1669
Mailing address
4411 MEDICAL DR STE 300, SAN ANTONIO, TX 78229-3824
(210) 614-5400
(210) 614-2413

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
L9047
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
170128604
TX
01
8DB260
BCBS OF TX
TX
01
P01076448
RAILROAD MEDICARE
TX
01
TXB142173
MEDICARE
TX
Enumeration date
10/27/2005
Last updated
05/20/2022
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