Provider Demographics
NPI:1093854010
Name:VACHHANI, NITESH (MD)
Entity Type:Individual
Prefix:
First Name:NITESH
Middle Name:
Last Name:VACHHANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 MAIN ST STE 401
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-3244
Mailing Address - Country:US
Mailing Address - Phone:713-459-4326
Mailing Address - Fax:281-903-5002
Practice Address - Street 1:1601 MAIN ST STE 401
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-3244
Practice Address - Country:US
Practice Address - Phone:281-342-9530
Practice Address - Fax:281-342-9564
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2011-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2006-0223207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX215508701Medicaid
TX8CM673OtherBCBS
TX215508701Medicaid