Provider Demographics
NPI:1427779131
Name:GREATER DALLAS ARYA SAMAJ CANCER CLINIC
Entity type:Organization
Organization Name:GREATER DALLAS ARYA SAMAJ CANCER CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:VIJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:BHALLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-733-0363
Mailing Address - Street 1:PO BOX 514
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-0010
Mailing Address - Country:US
Mailing Address - Phone:214-733-0363
Mailing Address - Fax:313-731-3680
Practice Address - Street 1:833 E ARAPAHO RD STE 205
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-2269
Practice Address - Country:US
Practice Address - Phone:972-635-3680
Practice Address - Fax:313-731-3680
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GREATER DALLAS ARYA SAMAJ
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-09-09
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Single Specialty