Individual
DEBASISH DASGUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 510-1186
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 531-5000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01056530A
IN
207R00000X
Internal Medicine Physician
Primary
P4298
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000289034
ANTHEM
IN
05
—
200425520
—
IN
05
—
306275401
—
TX
01
—
75-2616977-042
TRICARE
TX
01
—
8DJ983
BCBS
TX
01
—
8HN121
BCBS
TX
01
—
P01092666
MCRRR
TX
Enumeration date
04/26/2006
Last updated
12/23/2024
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