Provider Demographics
NPI:1982694253
Name:SHENOY, VASUDEV B (MD)
Entity Type:Individual
Prefix:DR
First Name:VASUDEV
Middle Name:B
Last Name:SHENOY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:509 W TIDWELL RD STE 130
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77091-4356
Mailing Address - Country:US
Mailing Address - Phone:713-691-3649
Mailing Address - Fax:713-697-4006
Practice Address - Street 1:509 W TIDWELL RD STE 130
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77091-4356
Practice Address - Country:US
Practice Address - Phone:713-691-3649
Practice Address - Fax:713-697-4006
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE7276207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX116698505Medicaid
TX170453801Medicaid
TX00461VMedicare ID - Type UnspecifiedGROUP PROVIDER NUMBER
TXP00021821Medicare ID - Type UnspecifiedRAILROAD MEICARE
TX8A8719Medicare ID - Type UnspecifiedPROVIDER NUMBER
TX116698505Medicaid