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General NPI Number Information
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NPI Number | 1457575615
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Entity Type | Individual
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Provider Name | SWAPNIL VAIDYA MD, PHD
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Gender | Male
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 03/28/2024
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Provider Practice Location Address
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Address Line | 9433 N BEACH ST STE 111
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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 | 817-428-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 9433 N BEACH ST STE 111
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City | FORT WORTH
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State | TX
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Zip | 76244-6306
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Country | US
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Telephone | 817-428-7000
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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 | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | P0805
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RA0201X
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Taxonomy Name | Allergy & Immunology (Internal Medicine) Physician
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License Number | P0805
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | P0805
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License Number State | TX
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