Provider Demographics
NPI:1548222193
Name:DAS, SAJAL (MD)
Entity Type:Individual
Prefix:
First Name:SAJAL
Middle Name:
Last Name:DAS
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 1:7 MEDICAL PKWY
Mailing Address - Street 2:DALLAS MEDICAL CENTER
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7829
Mailing Address - Country:US
Mailing Address - Phone:972-888-7264
Mailing Address - Fax:972-941-6666
Practice Address - Street 1:7 MEDICAL PKWY
Practice Address - Street 2:DALLAS MEDICAL CENTER
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7829
Practice Address - Country:US
Practice Address - Phone:972-888-7264
Practice Address - Fax:972-941-6666
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY238680207R00000X
MO2005035770207R00000X
PAMD431315207R00000X
TXN1603207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00963300OtherRAILROAD MCARE THRU IEPOS @ TRMC
TX200073905Medicaid
TX200073914Medicaid
TX200073905Medicaid
TXTXB128367Medicare PIN
TXP00963300OtherRAILROAD MCARE THRU IEPOS @ TRMC
TXTXB100791Medicare PIN
TXTXB100785Medicare PIN