Provider Demographics
NPI:1003086976
Name:KHERA, VANDANA (MD)
Entity Type:Individual
Prefix:
First Name:VANDANA
Middle Name:
Last Name:KHERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18717 UNIVERSITY BLVD BLDG 2
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4633
Mailing Address - Country:US
Mailing Address - Phone:281-208-3322
Mailing Address - Fax:281-208-3393
Practice Address - Street 1:18717 UNIVERSITY BLVD BLDG 2
Practice Address - Street 2:SUITE 105
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-4633
Practice Address - Country:US
Practice Address - Phone:281-208-3322
Practice Address - Fax:281-208-3393
Is Sole Proprietor?:No
Enumeration Date:2008-03-07
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA234650207R00000X
TXQ2150207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX356361101Medicaid
TX8FM737OtherBLUE CROSS BLUE SHIELD
TX478424ZSVEMedicare PIN