Provider Demographics
NPI:1639494230
Name:VASANTH, PAYASWINI (MD)
Entity Type:Individual
Prefix:DR
First Name:PAYASWINI
Middle Name:
Last Name:VASANTH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2217 IVAN ST
Mailing Address - Street 2:APT 615
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-1074
Mailing Address - Country:US
Mailing Address - Phone:703-577-8706
Mailing Address - Fax:
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:POB-2 HQ1.202 M/C 8516
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-1930
Practice Address - Country:US
Practice Address - Phone:214-645-5418
Practice Address - Fax:214-645-1945
Is Sole Proprietor?:No
Enumeration Date:2010-04-07
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBPI-0036671207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine