Basic Information
| Provider Information | |||||||||
| NPI: | 1740402957 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PRADHAN | ||||||||
| FirstName: | ANUPAM | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7777 FOREST LN | ||||||||
| Address2: | SUITE C-300G | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752302571 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9725665564 | ||||||||
| FaxNumber: | 9725663556 | ||||||||
| Practice Location | |||||||||
| Address1: | 7777 FOREST LN | ||||||||
| Address2: | SUITE C-300G | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752302571 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9725665564 | ||||||||
| FaxNumber: | 9725663556 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2007 | ||||||||
| LastUpdateDate: | 01/26/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | P3953 | TX | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.