Healthcare Provider Details

I. General information

NPI: 1225030281
Provider Name (Legal Business Name): VISHAL B MALPANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2005
Last Update Date: 03/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 ROSEWOOD AVE
AUSTIN TX
78702-2206
US

IV. Provider business mailing address

2222 ROSEWOOD AVE
AUSTIN TX
78702-2206
US

V. Phone/Fax

Practice location:
  • Phone: 512-465-4840
  • Fax: 512-465-4841
Mailing address:
  • Phone: 512-465-4840
  • Fax: 512-465-4841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20684
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberN7456
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: