Provider Demographics
NPI:1881672749
Name:JAISWAL, SAPNA (MD)
Entity Type:Individual
Prefix:DR
First Name:SAPNA
Middle Name:
Last Name:JAISWAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 HARRY HINES BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-6234
Mailing Address - Country:US
Mailing Address - Phone:214-393-2940
Mailing Address - Fax:214-393-2945
Practice Address - Street 1:5959 HARRY HINES BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-6234
Practice Address - Country:US
Practice Address - Phone:214-393-2940
Practice Address - Fax:214-393-2945
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9745207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0051MPOtherBCBS
TXI41547Medicare UPIN
TX0051MPOtherBCBS