Provider Demographics
NPI:1093945172
Name:DESAI, POOJA (MD)
Entity Type:Individual
Prefix:
First Name:POOJA
Middle Name:
Last Name:DESAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12201 MERIT DR STE 550
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-3131
Mailing Address - Country:US
Mailing Address - Phone:972-331-9700
Mailing Address - Fax:972-331-9833
Practice Address - Street 1:12201 MERIT DR STE 550
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-3131
Practice Address - Country:US
Practice Address - Phone:972-331-9700
Practice Address - Fax:972-331-9833
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS04-377692080P0202X
TXBP10034801208000000X
TXS74172080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics