Provider Demographics
NPI:1033315171
Name:DESHPANDE, DEVYANI V (MD)
Entity Type:Individual
Prefix:MRS
First Name:DEVYANI
Middle Name:V
Last Name:DESHPANDE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7200 N STATE HWY 161
Mailing Address - Street 2:SUITE 220
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039
Mailing Address - Country:US
Mailing Address - Phone:214-689-7806
Mailing Address - Fax:214-689-5970
Practice Address - Street 1:7200 N STATE HWY 161
Practice Address - Street 2:SUITE 220
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039
Practice Address - Country:US
Practice Address - Phone:214-689-7806
Practice Address - Fax:214-689-5970
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN3008207RI0200X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX210443201Medicaid
TX210443201Medicaid