Individual
RADHA GOPAL IYENGAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1105 CENTRAL EXPY N STE 2100, MEDICAL BUILDING 2, ALLEN, TX 75013-6120
(972) 747-6401
(972) 747-6405
Mailing address
1105 CENTRAL EXPY N STE 2100, MEDICAL BUILDING 2, ALLEN, TX 75013-6120
(972) 747-6401
(972) 747-6405
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
059085
GA
208600000X
Surgery Physician
N1354
TX
2086X0206X
Surgical Oncology Physician
Primary
N1354
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206326501
—
TX
Enumeration date
03/15/2007
Last updated
10/07/2019
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