Basic Information
| Provider Information | |||||||||
| NPI: | 1184608440 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KHURANA | ||||||||
| FirstName: | RENUKA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 660599 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752660599 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2145904105 | ||||||||
| FaxNumber: | 2145904162 | ||||||||
| Practice Location | |||||||||
| Address1: | 4444 S HAMPTON RD | ||||||||
| Address2: | OAK WEST HEALTH CENTER | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752321057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2142661450 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | H3090 | TX | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.