Provider Demographics
NPI:1699755082
Name:THAKUR, KALPANA (MD)
Entity type:Individual
Prefix:
First Name:KALPANA
Middle Name:
Last Name:THAKUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4108 W. SPRING CREEK PARKWAY
Mailing Address - Street 2:SUITE E200
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024
Mailing Address - Country:US
Mailing Address - Phone:972-599-0400
Mailing Address - Fax:972-599-0410
Practice Address - Street 1:4108 W. SPRING CREEK PARKWAY
Practice Address - Street 2:SUITE E200
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024
Practice Address - Country:US
Practice Address - Phone:972-599-0400
Practice Address - Fax:972-599-0410
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2836207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX178720201Medicaid
TX8F8335Medicare PIN
TX178720201Medicaid