1508835406 NPI number — DR. CHRISTOPHER VARGHESE MAANI M.D.

Table of content: (NPI 1497187173)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508835406 NPI number — DR. CHRISTOPHER VARGHESE MAANI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAANI
Provider First Name:
CHRISTOPHER
Provider Middle Name:
VARGHESE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1508835406
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/26/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
BROOKE ARMY MEDICAL CENTER - BAMC DEPT OF ANESTHESIA
Provider Second Line Business Mailing Address:
3551 ROGER BROOKE DRIVE; 2ND FLOOR, COTO
Provider Business Mailing Address City Name:
FORT SAM HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78234
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3400 RAWLEY E CHAMBERS AVE
Provider Second Line Business Practice Location Address:
ISR CLINICAL DIV ISR ANESTHESIA BAMC 4RTH FLR
Provider Business Practice Location Address City Name:
FORT SAM HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78234
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-569-9782
Provider Business Practice Location Address Fax Number:
210-354-7174
Provider Enumeration Date:
03/15/2006

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: 207LC0200X , with the licence number:  01059692A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207LC0200X , with the licence number: M7388 , 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)





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