Provider Demographics
NPI:1225030281
Name:MALPANI, VISHAL B (MD)
Entity Type:Individual
Prefix:DR
First Name:VISHAL
Middle Name:B
Last Name:MALPANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2222 ROSEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-2206
Mailing Address - Country:US
Mailing Address - Phone:512-465-4840
Mailing Address - Fax:512-465-4841
Practice Address - Street 1:2222 ROSEWOOD AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-2206
Practice Address - Country:US
Practice Address - Phone:512-465-4840
Practice Address - Fax:512-465-4841
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20684207Q00000X
TXN7456207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVCA7346OtherRAILROAD MEDICARE GROUP
WV3003260000Medicaid
LA1570168Medicaid
TX217161302Medicaid
WVP00647699OtherRAILROAD MEDICARE
TXTXB131488OtherWELLMED PTAN
TXTXB131488OtherWELLMED PTAN
WVMA6037391Medicare PIN