| Doctor Name: | VIDISHA GHOLE |
| NPI Number: | 1447344809 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 054566 |
| Business Practice Address: | 4500 S Lancaster Rd Dallas, TX - 752167167 |
| Business Phone Number: | 2148570185 |
| Business Fax Number: | 2148570173 |
| Mailing Address: | 5323 N Macarthur Blvd, # 2074 IRVING |
| State: | TX |
| Postal Code: | 750383102 |
| Phone Number: | 2142565907 |
| Fax Number: | |
| NPI Enumeration Date: | 10/02/2006 |
| NPI Last Update Date: | 07/16/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | 054566 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |