Provider Demographics
NPI:1912187014
Name:PANKAJ THAPAR, MD, PA
Entity Type:Organization
Organization Name:PANKAJ THAPAR, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PANKAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:THAPAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-668-7460
Mailing Address - Street 1:PO BOX 271731
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75027-1731
Mailing Address - Country:US
Mailing Address - Phone:214-222-4370
Mailing Address - Fax:
Practice Address - Street 1:475 ELM ST STE 201
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-3764
Practice Address - Country:US
Practice Address - Phone:214-222-4370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00W036Medicare PIN