Provider Demographics
NPI:1982660759
Name:VANDSHEKARI, NAHID (MD)
Entity Type:Individual
Prefix:DR
First Name:NAHID
Middle Name:
Last Name:VANDSHEKARI
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 1:5555 N MESA ST STE 400
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-5424
Mailing Address - Country:US
Mailing Address - Phone:915-320-9476
Mailing Address - Fax:915-275-5510
Practice Address - Street 1:5555 N MESA ST STE 400
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-5424
Practice Address - Country:US
Practice Address - Phone:915-320-9476
Practice Address - Fax:915-275-5510
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-21
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX018430251E00000X, 207RH0002X
TXL5938207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No251E00000XAgenciesHome Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXBV7863168OtherDEA
TX70126090OtherDPS
TX70126090OtherDPS