MEDICARE: NITHIYANANDHI PANDIAN 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	207R00000X	Internal Medicine Physician	N2229	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	N2229	OTHER	TX	TEXAS MEDICAL LICENSE

General Provider Information

NPI Number	:	1710944251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NITHIYANANDHI PANDIAN MD

Provider Business Mailing Address
First Line	:	3120 SAN SEBASTIAN DR
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75006-5208
Country	:	US
Telephone Number	:	254-717-1920
Fax Number	:

Provider Business Practice Location Address
First Line	:	DALLAS VA MEDICAL CENTER
Second Line	:	4500 SOUTH LANCASTER ROAD
City	:	DALLAS
State	:	TX
Zip	:	75216-7521
Country	:	US
Telephone Number	:	214-857-2742
Fax Number	:

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

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	04/26/2023

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