1154313898 NPI number — DR. VISHAN GIYANANI MD

Table of content: DR. VISHAN GIYANANI MD (NPI 1154313898)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154313898 NPI number — DR. VISHAN GIYANANI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GIYANANI
Provider First Name:
VISHAN
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154313898
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/25/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2415 E YANDELL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EL PASO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79903-3616
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
915-577-0111
Provider Business Mailing Address Fax Number:
915-533-2568

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2415 E YANDELL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EL PASO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79903-3616
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-577-0111
Provider Business Practice Location Address Fax Number:
915-533-2568
Provider Enumeration Date:
08/18/2005

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: 2085R0202X , with the licence number:  G7813 , 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: 77297 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1154313898 . This is a "MEDICARE RR" identifier . This identifiers is of the category "OTHER".
  • Identifier: MDG7813 . This is a "WORKERS COMP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 100900 . This is a "SUPERIOR SSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 138569203 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 300107708 . This is a "MEDICARE RR" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 85614Y . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: GH05840081 . This is a "EL PASO FIRST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 61837 . This is a "AMERIGROUP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 00077297 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00U08W . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 138569214 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 54831 . This is a "PRESBY MEDICAID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 300061069 . This is a "MEDICARE RR" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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