MEDICARE: DR. SATISH V VAYUVEGULA M.D.

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	202K00000X	Phlebology Physician	036106606	IL
2	202K00000X	Phlebology Physician	35094576	OH
3	202K00000X	Phlebology Physician	P2390	TX
4	207P00000X	Emergency Medicine Physician	35094576	OH
5	207P00000X	Emergency Medicine Physician	P2390	TX
6	2086S0129X	Vascular Surgery Physician	036106606	IL
7	208D00000X	General Practice Physician	P2390	TX
8	208D00000X	General Practice Physician	35094576	OH
9	207RC0000X	Cardiovascular Disease Physician	P2390	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	194873	OTHER	PA	MEDICARE GROUP PTAN
2	P00888630	OTHER	TN	MEDICARE RAILROAD INDIVIDUAL PTAN
3	789511	OTHER	IL	MEDICARE GROUP PTAN
4	DC4196	OTHER	IL	MEDICARE RAILROAD GROUP PTAN
5	P00167671	OTHER	IL	MEDICARE RAILROAD INDIVIDUAL PTAN
6	P00889814	OTHER	MO	MEDICARE RAILROAD INDIVIDUAL PTAN
7	DF3698	OTHER	MO	MEDICARE RAILROAD GROUP PTAN
8	DG0518	OTHER	VA	MEDICARE RAILROAD GROUP PTAN
9	G01618	OTHER	VA	MEDICARE GROUP PTAN
10	W650000	OTHER	MO	MEDICARE GROUP PTAN
12	789510	OTHER	IL	MEDICARE GROUP PTAN
13	P00468401	OTHER	VA	MEDICARE RAILROAD INDIVIDUAL PTAN
14	3733226	OTHER	TN	MEDICARE GROUP PTAN
15	DE5194	OTHER	TN	MEDICARE RAILROAD GROUP PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477547875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SATISH V VAYUVEGULA M.D.

Provider Business Mailing Address
First Line	:	4721 HOLLAND LN
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75010-4594
Country	:	US
Telephone Number	:	312-718-2368
Fax Number	:

Provider Business Practice Location Address
First Line	:	4721 HOLLAND LN
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75010-4594
Country	:	US
Telephone Number	:	312-718-2368
Fax Number	:

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

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	02/26/2025

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Directions to “ DR. SATISH V VAYUVEGULA M.D.” Practice Location

Language	Start Address	Practice Location

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