Provider Demographics
NPI:1770768210
Name:PANDYA, DEVESH MAHESH (MD)
Entity type:Individual
Prefix:
First Name:DEVESH
Middle Name:MAHESH
Last Name:PANDYA
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 1:1140 BUSINESS CENTER DR STE 202
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-2741
Mailing Address - Country:US
Mailing Address - Phone:713-800-0660
Mailing Address - Fax:713-827-1380
Practice Address - Street 1:2130 W HOLCOMBE BLVD
Practice Address - Street 2:10TH FLOOR
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3304
Practice Address - Country:US
Practice Address - Phone:713-600-0900
Practice Address - Fax:713-600-0070
Is Sole Proprietor?:No
Enumeration Date:2008-01-03
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN7568207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX281204201Medicaid
TX281204202Medicaid
TXTXB129121OtherMEDICARE PTAN
TXTXB129122OtherMEDICARE PTAN