Provider Demographics
NPI:1124202155
Name:KUNJAN P THAKOR MD PA
Entity Type:Organization
Organization Name:KUNJAN P THAKOR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KUNJAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:THAKOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-378-3242
Mailing Address - Street 1:5930 WEST PARKER ROAD ;SUITE 600
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093
Mailing Address - Country:US
Mailing Address - Phone:972-378-3242
Mailing Address - Fax:972-378-3206
Practice Address - Street 1:5930 W PARKER RD STE 600
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-6420
Practice Address - Country:US
Practice Address - Phone:972-378-3242
Practice Address - Fax:972-378-3206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX030035201Medicaid
0007EJOtherBLUE CROSS BLUE SHIELD