Provider Demographics
NPI:1467494542
Name:DUTTA, PARITOSH CHANDRA (MD)
Entity type:Individual
Prefix:DR
First Name:PARITOSH
Middle Name:CHANDRA
Last Name:DUTTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:PARITOSH
Other - Middle Name:CHANDRA
Other - Last Name:DUTTA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:275 W CAMPBELL RD
Mailing Address - Street 2:#650
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3601
Mailing Address - Country:US
Mailing Address - Phone:972-238-9065
Mailing Address - Fax:972-238-1974
Practice Address - Street 1:275 W CAMPBELL RD
Practice Address - Street 2:#650
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3601
Practice Address - Country:US
Practice Address - Phone:972-238-9065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE 7900207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2892757001OtherCIGNA PAL
TXB87642OtherUPIN
TX4063099OtherAETNA
TX2287642OtherBCBS BLUE LINK
TX8BC670OtherBCBS
TXB87642OtherUPIN