Basic Information
| Provider Information | |||||||||
| NPI: | 1821222084 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JALANDHARA | ||||||||
| FirstName: | PRIYANKA | ||||||||
| MiddleName: | BACHUBHAI | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 W CANNON ST | ||||||||
| Address2: | |||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761043029 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8177257900 | ||||||||
| FaxNumber: | 6822071030 | ||||||||
| Practice Location | |||||||||
| Address1: | 3025 N TARRANT PKWY STE 170 | ||||||||
| Address2: | |||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 76177 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8177257900 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2009 | ||||||||
| LastUpdateDate: | 02/19/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 125055643 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RR0500X | MD20211 | ME | N | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 207RR0500X | R1783 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
No ID Information.