Provider Demographics
NPI:1891960969
Name:DESAI, VIPUL (MD)
Entity Type:Individual
Prefix:
First Name:VIPUL
Middle Name:
Last Name:DESAI
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 1:1111 MEDICAL PLAZA DRIVE
Mailing Address - Street 2:# 170
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380
Mailing Address - Country:US
Mailing Address - Phone:281-444-1303
Mailing Address - Fax:281-882-8269
Practice Address - Street 1:1111 MEDICAL PLAZA DRIVE
Practice Address - Street 2:# 170
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380
Practice Address - Country:US
Practice Address - Phone:281-444-1303
Practice Address - Fax:281-882-8269
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0971207RI0200X
AL29235208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease