1932127834 NPI number — MEGHANA G DANDEKAR MD

Table of content: MEGHANA G DANDEKAR MD (NPI 1932127834)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932127834 NPI number — MEGHANA G DANDEKAR MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DANDEKAR
Provider First Name:
MEGHANA
Provider Middle Name:
G
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DANDEKAR
Provider Other First Name:
MEGHANA
Provider Other Middle Name:
GUMASTE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1932127834
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/08/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6210 E HIGHWAY 290 STE 240
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78723-1144
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-231-5506
Provider Business Mailing Address Fax Number:
512-406-6216

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
801 E WHITESTONE BLVD
Provider Second Line Business Practice Location Address:
BLDG C
Provider Business Practice Location Address City Name:
CEDAR PARK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78613-5028
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-259-3467
Provider Business Practice Location Address Fax Number:
512-406-7303
Provider Enumeration Date:
07/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  L7346 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 176010003 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 176010002 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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