Provider Demographics
NPI:1285684944
Name:MODI, BIJAL J (MD)
Entity Type:Individual
Prefix:DR
First Name:BIJAL
Middle Name:J
Last Name:MODI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-0813
Practice Address - Street 1:8220 WALNUT HILL LN
Practice Address - Street 2:SUITE 700
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4427
Practice Address - Country:US
Practice Address - Phone:214-739-4175
Practice Address - Fax:214-987-4161
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01061784A207RH0003X
TXM8846207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX203449801Medicaid
1285684944OtherNPI
TX203449802Medicaid
TX8CA991OtherBLUECROSS BLUESHIELD OF TEXAS
TXP00829938OtherRAILROAD MEDICARE
TX8CA991OtherBLUECROSS BLUESHIELD OF TEXAS
I52272Medicare UPIN
TX203449802Medicaid