Provider Demographics
NPI:1265659106
Name:CHOUDHRY, VINEET (MD)
Entity Type:Individual
Prefix:
First Name:VINEET
Middle Name:
Last Name:CHOUDHRY
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 1:2217 PARK BEND DR
Mailing Address - Street 2:STE 220
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5674
Mailing Address - Country:US
Mailing Address - Phone:512-491-6542
Mailing Address - Fax:512-491-0161
Practice Address - Street 1:2217 PARK BEND DR STE 220
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5674
Practice Address - Country:US
Practice Address - Phone:512-491-6542
Practice Address - Fax:512-491-0161
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2031208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F20765Medicare PIN
TX0A3491Medicare PIN