Healthcare Provider Details

I. General information

NPI: 1255235529
Provider Name (Legal Business Name): INDU VIJAYAKUMAR NAIR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5016 S US HIGHWAY 75
DENISON TX
75020-4584
US

IV. Provider business mailing address

4108 WOOD RIVER TRL
PROSPER TX
75078-9847
US

V. Phone/Fax

Practice location:
  • Phone: 903-416-4000
  • Fax:
Mailing address:
  • Phone: 224-276-9915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number1108270
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: