1669558136 NPI number — DR. VED V AGGARWAL MD

Table of content: DR. VED V AGGARWAL MD (NPI 1669558136)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669558136 NPI number — DR. VED V AGGARWAL MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AGGARWAL
Provider First Name:
VED
Provider Middle Name:
V
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:
1669558136
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/26/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 LIPSCOMB ST STE 110
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT WORTH
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76104-3181
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-348-8600
Provider Business Mailing Address Fax Number:
871-348-8602

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 LIPSCOMB ST
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
FORT WORTH
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-348-8600
Provider Business Practice Location Address Fax Number:
817-870-2848
Provider Enumeration Date:
10/27/2006

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: 207L00000X , with the licence number:  K7495 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: K7495 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208VP0014X , with the licence number: K7495 , 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: P00222119 . This is a "RR MCR PTAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 14081505 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 612065800 . This is a "US DEPARTMENT OF LABOR" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8P0340 . This is a "BLUE CROSS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8203509 . This is a "WASHINGTON WC" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 1152807 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3488569 . This is a "AETNA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: P00222119 . This is a "MEDICARE PTAN" identifier . This identifiers is of the category "OTHER".




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