Basic Information
| Provider Information | |||||||||
| NPI: | 1295734408 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DAS | ||||||||
| FirstName: | TONY | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9330 LBJ FWY STE 800 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752434310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9727925700 | ||||||||
| FaxNumber: | 2145041170 | ||||||||
| Practice Location | |||||||||
| Address1: | 12740 HILLCREST RD STE 265 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2148141550 | ||||||||
| FaxNumber: | 2148141350 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2005 | ||||||||
| LastUpdateDate: | 01/22/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | H9877 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RI0011X | H9877 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
ID Information
| ID | Type | State | Issuer | Description | 060067351 | 01 | TX | RAILROAD | OTHER | 110125249 | 01 | TX | RAILROAD | OTHER | 1236671 | 05 | TX | MEDICAID | 89X466 | 01 | TX | BCBS | OTHER | 123667104 | 05 | TX | MEDICAID | P00044326 | 01 | TX | RAILROAD | OTHER |