MEDICARE: MAHESH CANDIAH THIAGARAJAH 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	207P00000X	Emergency Medicine Physician	L9928	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00364150	OTHER	TX	RAILROAD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	8W0730	OTHER	TX	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	8W1782	OTHER	TX	BCBS
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386689677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAHESH CANDIAH THIAGARAJAH MD

Provider Business Mailing Address
First Line	:	5555 E MOCKINGBIRD LN
Second Line	:	1108
City	:	DALLAS
State	:	TX
Zip	:	75206-5364
Country	:	US
Telephone Number	:	214-217-1911
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 W MAIN ST
Second Line	:
City	:	LEWISVILLE
State	:	TX
Zip	:	75057-3629
Country	:	US
Telephone Number	:	972-420-1000
Fax Number	:

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

Provider Enumeration Date	:	06/19/2006
Last Update Date	:	07/19/2024

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