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General NPI Number Information
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NPI Number | 1104155001
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Entity Type | Organization
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Legal Business Name | VIJAY K MOHAN MD PA
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Dates
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Enumeration Date | 12/24/2009
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Last Update Date | 03/03/2010
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Provider Practice Location Address
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Address Line | 104 E 30TH ST SUITE 2
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City | PAMPA
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State | TX
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Zip | 79065-2822
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Country | US
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Telephone | 806-669-3303
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Fax | 806-669-6611
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Provider Business Mailing Address
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Address Line | 104 E 30TH ST SUITE 2
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City | PAMPA
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State | TX
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Zip | 79065-2822
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Country | US
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Telephone | 806-669-3303
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Fax | 806-669-6611
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VIJAY K MOHAN
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Credential | MD PA
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Telephone | 806-669-3303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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