Provider Demographics
NPI:1164717401
Name:DOBARIYA, MANOJKUMAR A (MD)
Entity Type:Individual
Prefix:
First Name:MANOJKUMAR
Middle Name:A
Last Name:DOBARIYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3427 TRINITY MILLS RD STE 800
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-6203
Mailing Address - Country:US
Mailing Address - Phone:972-478-8800
Mailing Address - Fax:972-478-8813
Practice Address - Street 1:3427 TRINITY MILLS RD STE 800
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-6203
Practice Address - Country:US
Practice Address - Phone:972-478-8800
Practice Address - Fax:972-478-8813
Is Sole Proprietor?:No
Enumeration Date:2011-06-15
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA128975207Q00000X
ARE-8031207Q00000X
390200000X
TXQ0748207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR199727001Medicaid