Provider Demographics
NPI:1689808149
Name:DESAI, SNEHAL SUBODH (MD)
Entity Type:Individual
Prefix:DR
First Name:SNEHAL
Middle Name:SUBODH
Last Name:DESAI
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 1:1 BAYLOR PLZ # BCM711
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3411
Mailing Address - Country:US
Mailing Address - Phone:713-798-4808
Mailing Address - Fax:
Practice Address - Street 1:7200 CAMBRIDGE STREET
Practice Address - Street 2:10TH FLOOR
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4202
Practice Address - Country:US
Practice Address - Phone:713-798-1750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP200292032085R0001X
TXN43772085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX285779906Medicaid
TX8FU661OtherBLUE CROSS BLUE SHIELD
TX1689808149OtherBLUE CROSS BLUE SHIELD
TX285779904Medicaid
TX1689808149OtherBLUE CROSS BLUE SHIELD
TX285779904Medicaid
TXTXB130259Medicare PIN