Healthcare Provider Details

I. General information

NPI: 1982660759
Provider Name (Legal Business Name): NAHID VANDSHEKARI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2006
Last Update Date: 03/04/2024
Certification Date: 03/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 N MESA ST STE 400
EL PASO TX
79912-5424
US

IV. Provider business mailing address

5555 N MESA ST STE 400
EL PASO TX
79912-5424
US

V. Phone/Fax

Practice location:
  • Phone: 915-320-9476
  • Fax: 915-275-5510
Mailing address:
  • Phone: 915-320-9476
  • Fax: 915-275-5510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number018430
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number018430
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberL5938
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: