Provider Demographics
NPI:1659691772
Name:MADKAN, VANDANA (MD)
Entity Type:Individual
Prefix:DR
First Name:VANDANA
Middle Name:
Last Name:MADKAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5502 SCHUMACHER LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-6812
Mailing Address - Country:US
Mailing Address - Phone:404-931-0604
Mailing Address - Fax:
Practice Address - Street 1:7616 BRANFORD PL STE 240
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3794
Practice Address - Country:US
Practice Address - Phone:281-240-4313
Practice Address - Fax:281-240-3646
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-11
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA124332207N00000X
TXM2384207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology