Provider Demographics
NPI:1023706249
Name:DUGGAL, SHIVANGINI
Entity type:Individual
Prefix:DR
First Name:SHIVANGINI
Middle Name:
Last Name:DUGGAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER EL PASO,
Mailing Address - Street 2:4800 ALBERTA AVE MSC 41007
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905
Mailing Address - Country:US
Mailing Address - Phone:915-215-4116
Mailing Address - Fax:915-215-8641
Practice Address - Street 1:TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER EL PASO,
Practice Address - Street 2:4800 ALBERTA AVE MSC 41007
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905
Practice Address - Country:US
Practice Address - Phone:915-215-4116
Practice Address - Fax:915-215-8641
Is Sole Proprietor?:No
Enumeration Date:2023-04-26
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXBP10085718207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program