MEDICARE: PREM S PILLAY 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	207UN0901X	Nuclear Cardiology Physician	M2754	TX
2	207RC0000X	Cardiovascular Disease Physician	38206	NH
3	207RC0000X	Cardiovascular Disease Physician	M2754	TX
4	207RC0000X	Cardiovascular Disease Physician	MEDPHYSCOMLIC160330	MT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00286291	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0008NG	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	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	:	1669438552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PREM S PILLAY MD

Provider Business Mailing Address
First Line	:	1960 W FRYE RD STE 5
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85224-6238
Country	:	US
Telephone Number	:	480-917-5900
Fax Number	:	520-836-6663

Provider Business Practice Location Address
First Line	:	1960 W FRYE RD STE 5
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85224-6238
Country	:	US
Telephone Number	:	480-917-5900
Fax Number	:	520-836-6663

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

Provider Enumeration Date	:	04/21/2006
Last Update Date	:	12/11/2025

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Directions to “ PREM S PILLAY MD” Practice Location

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