Provider Demographics
NPI:1699722108
Name:DHAR, PRADIP K (MD)
Entity type:Individual
Prefix:
First Name:PRADIP
Middle Name:K
Last Name:DHAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5714 SPOHN DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-4116
Mailing Address - Country:US
Mailing Address - Phone:361-561-0005
Mailing Address - Fax:361-561-0006
Practice Address - Street 1:5714 SPOHN DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4116
Practice Address - Country:US
Practice Address - Phone:361-561-0005
Practice Address - Fax:361-561-0006
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-28
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL22222080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX120265OtherSUPERIOR HEALTHPLAN
TX145533907OtherMEDICAID CSHCN
TX145533906Medicaid
TX8H9854OtherBCBSTX
TX145533906Medicaid
TX8A7442Medicare ID - Type Unspecified