=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861499808
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MAHESH GHANSHYAM CHANGLANI MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/06/2005
-----------------------------------------------------
Last Update Date | 04/15/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5521 N MCCOLL RD
-----------------------------------------------------
City | MCALLEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78504-2208
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-362-8420
-----------------------------------------------------
Fax | 956-362-8448
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 4449
-----------------------------------------------------
City | MCALLEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78502-4449
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-362-2171
-----------------------------------------------------
Fax | 956-618-3051
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | 10976R
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | P8456
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------