MEDICARE: NITESH VACHHANI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	2006-0223	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8CM673	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1093854010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NITESH VACHHANI MD

Provider Business Mailing Address
First Line	:	1601 MAIN ST STE 401
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77469-3244
Country	:	US
Telephone Number	:	713-459-4326
Fax Number	:	281-903-5002

Provider Business Practice Location Address
First Line	:	1601 MAIN ST STE 401
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77469-3244
Country	:	US
Telephone Number	:	281-342-9530
Fax Number	:	281-342-9564

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	08/14/2011

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