Provider Demographics
NPI:1083849970
Name:MANDHADI, ASWINI (MD)
Entity Type:Individual
Prefix:
First Name:ASWINI
Middle Name:
Last Name:MANDHADI
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 1:4301 GARTH ROAD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521
Mailing Address - Country:US
Mailing Address - Phone:281-420-8747
Mailing Address - Fax:281-420-8480
Practice Address - Street 1:4301 GARTH ROAD
Practice Address - Street 2:SUITE 400
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521
Practice Address - Country:US
Practice Address - Phone:281-420-8747
Practice Address - Fax:281-420-8480
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-20
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10035429390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program