Provider Demographics
NPI:1730188293
Name:AGGARWAL, MONIKA (MD)
Entity type:Individual
Prefix:DR
First Name:MONIKA
Middle Name:
Last Name:AGGARWAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MONIKA
Other - Middle Name:
Other - Last Name:GUPTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:14501 MONTFORT DR APT 820
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-8554
Mailing Address - Country:US
Mailing Address - Phone:510-366-3673
Mailing Address - Fax:
Practice Address - Street 1:14501 MONTFORT DR APT 820
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-8554
Practice Address - Country:US
Practice Address - Phone:510-366-3673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2386207RN0300X
TXP6760207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT80392Medicaid
SC3493Medicare PIN
SCH88416Medicare UPIN