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General NPI Number Information
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NPI Number | 1629310883
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Entity Type | Individual
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Provider Name | SHASHANK VIJAY GANDHI MD
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Gender | Male
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Dates
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Enumeration Date | 03/26/2013
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Last Update Date | 08/22/2024
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Provider Practice Location Address
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Address Line | 4510 MEDICAL CENTER DR STE 301
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City | MCKINNEY
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State | TX
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Zip | 75069-1603
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Country | US
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Telephone | 972-608-5000
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Fax | 972-608-5068
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Provider Business Mailing Address
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Address Line | 6020 W PARKER RD STE 200
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City | PLANO
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State | TX
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Zip | 75093-8172
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Country | US
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Telephone | 972-608-5000
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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 | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 101231
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | T1707
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License Number State | TX
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