Provider Demographics
NPI:1295734408
Name:DAS, TONY S (MD)
Entity type:Individual
Prefix:
First Name:TONY
Middle Name:S
Last Name:DAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9330 LBJ FWY STE 800
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-4310
Mailing Address - Country:US
Mailing Address - Phone:972-792-5700
Mailing Address - Fax:214-504-1170
Practice Address - Street 1:12720 HILLCREST RD STE 300
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2089
Practice Address - Country:US
Practice Address - Phone:214-814-1550
Practice Address - Fax:214-814-1350
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9877207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1236671Medicaid
TX110125249OtherRAILROAD
TX89X466OtherBCBS
TX123667104Medicaid
TXP00044326OtherRAILROAD
TX060067351OtherRAILROAD
F79744Medicare UPIN
TX83G908Medicare ID - Type Unspecified
TX89X466Medicare PIN