Provider Demographics
NPI:1831350461
Name:PUNATAR, ANKIT D (MD)
Entity type:Individual
Prefix:DR
First Name:ANKIT
Middle Name:D
Last Name:PUNATAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 GASTON AVE
Mailing Address - Street 2:4 ROBERTS
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-2017
Mailing Address - Country:US
Mailing Address - Phone:214-820-3000
Mailing Address - Fax:214-820-3022
Practice Address - Street 1:3500 GASTON AVE
Practice Address - Street 2:4 ROBERTS
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2017
Practice Address - Country:US
Practice Address - Phone:214-820-3000
Practice Address - Fax:214-820-3022
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ42185207R00000X
TXP0277207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX285687403Medicaid
TX8CZ869OtherBCBSTX
TX285267402Medicaid
TX285267401Medicaid
TX2856874-04Medicaid
TX285687405Medicaid
TXP01279716OtherMEDICARE RAILROAD
TX285267401Medicaid
TXP01031858Medicare PIN
TXTXB140515Medicare PIN
TXTXB138551Medicare PIN
TX266876YKTPMedicare PIN