Provider Demographics
NPI:1235130295
Name:BOSE, SAROJINI G (MD)
Entity Type:Individual
Prefix:DR
First Name:SAROJINI
Middle Name:G
Last Name:BOSE
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 1:801 E NOLANA AVE STE 13A
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-6112
Mailing Address - Country:US
Mailing Address - Phone:956-686-2700
Mailing Address - Fax:956-686-2708
Practice Address - Street 1:801 E NOLANA AVE STE 13A
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-6112
Practice Address - Country:US
Practice Address - Phone:956-686-2700
Practice Address - Fax:956-686-2708
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3248208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148015407Medicaid
TX148015412Medicaid
TX158413802Medicaid
TX217147202Medicaid
TX148015402Medicaid
TX148015406Medicaid
TX148015414Medicaid
TX158413801Medicaid
TX148015409Medicaid
TX148015413Medicaid
TX158413806Medicaid
TX203222901Medicaid
TX203222902Medicaid
TX148015403Medicaid
TX158413804Medicaid
TX148015405Medicaid
TX148015410Medicaid
TX148015411Medicaid
TX158413803Medicaid
TX158413805Medicaid
TX217147201Medicaid
TX148015401Medicaid
TX148015404Medicaid
TX148015408Medicaid
TX158413807Medicaid
TX203999203Medicaid
TX217147201Medicaid