Individual
DEEPTHI THOTAKURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1105 CENTRAL EXPY N STE 320, ALLEN, TX 75013-6104
(469) 467-4392
(469) 342-6750
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-9800
(972) 234-2987
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
BP10054296
TX
207RH0003X
Hematology & Oncology Physician
Primary
R7616
TX
207RX0202X
Medical Oncology Physician
R7616
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BP10054296
PIT
TX
Enumeration date
06/22/2015
Last updated
06/03/2022
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