Provider Demographics
NPI:1497041511
Name:PAL, ANANDITA (DO)
Entity Type:Individual
Prefix:
First Name:ANANDITA
Middle Name:
Last Name:PAL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2122 WINDING HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-5101
Mailing Address - Country:US
Mailing Address - Phone:832-798-1688
Mailing Address - Fax:
Practice Address - Street 1:204A ANDY LN
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-7707
Practice Address - Country:US
Practice Address - Phone:832-798-1688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10041320208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics