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General NPI Number Information
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NPI Number | 1962898106
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Entity Type | Individual
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Provider Name | KSHITIJ MANCHANDA MD
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Gender | Male
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Dates
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Enumeration Date | 04/14/2015
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 5757 WARREN PARKWAY PROFESSIONAL OFFICE BUILDING II, SUITE 180
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City | FRISCO
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State | TX
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Zip | 75034
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Country | US
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Telephone | 214-618-5502
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Fax | 214-618-5503
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Provider Business Mailing Address
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Address Line | 5631 LAGUNA DR
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City | FRISCO
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State | TX
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Zip | 75036-3393
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Country | US
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Telephone | 469-682-5260
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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 | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number | S2107
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License Number State | TX
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