Provider Demographics
NPI:1821223363
Name:DEBASIS DASGUPTA, MD, PA
Entity Type:Organization
Organization Name:DEBASIS DASGUPTA, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBASIS
Authorized Official - Middle Name:
Authorized Official - Last Name:DASGUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-503-5300
Mailing Address - Street 1:12200 PARK CENTRAL DR
Mailing Address - Street 2:STE. 189
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-2100
Mailing Address - Country:US
Mailing Address - Phone:972-503-5300
Mailing Address - Fax:972-503-5301
Practice Address - Street 1:12200 PARK CENTRAL DR
Practice Address - Street 2:STE. 189
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-2100
Practice Address - Country:US
Practice Address - Phone:972-503-5300
Practice Address - Fax:972-503-5301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9671207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty