Provider Demographics
NPI:1619007788
Name:VASAVADA MEDICAL CONSULTANTS
Entity Type:Organization
Organization Name:VASAVADA MEDICAL CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RASENDU
Authorized Official - Middle Name:J
Authorized Official - Last Name:VASAVADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-485-9424
Mailing Address - Street 1:601 E SAN ANTONIO ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-6040
Mailing Address - Country:US
Mailing Address - Phone:361-485-9424
Mailing Address - Fax:361-579-0884
Practice Address - Street 1:601 E SAN ANTONIO ST
Practice Address - Street 2:SUITE 100
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-6040
Practice Address - Country:US
Practice Address - Phone:361-485-9424
Practice Address - Fax:361-579-0884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4284174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG64967Medicare UPIN