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General NPI Number Information
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NPI Number | 1396068870
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Entity Type | Individual
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Provider Name | RADHIKA VAYANI DO
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Gender | Female
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Dates
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Enumeration Date | 03/11/2010
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Last Update Date | 08/17/2020
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Provider Practice Location Address
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Address Line | 3800 NORTH TARRANT PARKWAY STE 210
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City | FORT WORTH
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State | TX
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Zip | 76244
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Country | US
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Telephone | 682-593-6660
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Fax | 888-289-2380
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Provider Business Mailing Address
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Address Line | 640 SHELDON DR
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City | TROPHY CLUB
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State | TX
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Zip | 76262-1800
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Country | US
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Telephone | 817-800-9102
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | N5455
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License Number State | TX
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