Provider Demographics
NPI:1831375799
Name:DEEPIKA MINNAL, M.D., P.A.
Entity type:Organization
Organization Name:DEEPIKA MINNAL, M.D., P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEEPIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:MINNAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-424-7915
Mailing Address - Street 1:2200 LOS RIOS BLVD
Mailing Address - Street 2:SUITE 128
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074
Mailing Address - Country:US
Mailing Address - Phone:972-424-7915
Mailing Address - Fax:972-424-3652
Practice Address - Street 1:2200 LOS RIOS BLVD
Practice Address - Street 2:SUITE 128
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074
Practice Address - Country:US
Practice Address - Phone:972-424-7915
Practice Address - Fax:972-424-3652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0181208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty