Provider Demographics
NPI:1265746457
Name:SHET, VINAY PRABHAKAR (MD)
Entity type:Individual
Prefix:
First Name:VINAY
Middle Name:PRABHAKAR
Last Name:SHET
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 1:2818 W LOOP 250 N
Mailing Address - Street 2:APT N208
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79705-3302
Mailing Address - Country:US
Mailing Address - Phone:432-559-3921
Mailing Address - Fax:
Practice Address - Street 1:5419 N LOVINGTON HWY
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-9100
Practice Address - Country:US
Practice Address - Phone:432-559-3921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-30
Last Update Date:2013-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10036945207R00000X
NMCS00218795207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine