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General NPI Number Information
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NPI Number | 1316191141
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Entity Type | Organization
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Legal Business Name | PANDYA MEDICAL P.A.
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Dates
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Enumeration Date | 11/06/2008
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Last Update Date | 03/15/2011
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Provider Practice Location Address
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Address Line | 14080 NACOGDOCHES RD # 313
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City | SAN ANTONIO
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State | TX
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Zip | 78247-1944
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Country | US
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Telephone | 210-281-1701
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Fax |
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Provider Business Mailing Address
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Address Line | 14080 NACOGDOCHES RD # 313
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City | SAN ANTONIO
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State | TX
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Zip | 78247-1944
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Country | US
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Telephone | 210-281-1701
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. MAYANK PANDYA
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Credential | M.D.
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Telephone | 210-281-1701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | N1039
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License Number State | TX
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