MEDICARE: ARJUN MOHANDAS 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	207R00000X	Internal Medicine Physician	K6655	TX

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	8CM958	OTHER	TX	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639123573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARJUN MOHANDAS M.D.

Provider Business Mailing Address
First Line	:	209 S CHURCH ST
Second Line	:
City	:	LOCKHART
State	:	TX
Zip	:	78644-2713
Country	:	US
Telephone Number	:	512-376-2999
Fax Number	:	512-376-5562

Provider Business Practice Location Address
First Line	:	209 S CHURCH ST
Second Line	:
City	:	LOCKHART
State	:	TX
Zip	:	78644-2713
Country	:	US
Telephone Number	:	512-376-2999
Fax Number	:	512-376-5562

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

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	12/11/2012

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