MEDICARE: MR. AVINASH CHANDRA VYAS 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	11243	OK
2	207RG0100X	Gastroenterology Physician	11243	OK

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

General Provider Information

NPI Number	:	1902878739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. AVINASH CHANDRA VYAS MD

Provider Business Mailing Address
First Line	:	3400 S DOUGLAS BLVD
Second Line	:	STE 301
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73150-1001
Country	:	US
Telephone Number	:	405-231-8888
Fax Number	:	405-772-4055

Provider Business Practice Location Address
First Line	:	3400 S DOUGLAS BLVD
Second Line	:	STE 301
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73150-1001
Country	:	US
Telephone Number	:	405-231-8888
Fax Number	:	405-772-4055

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

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	10/19/2020

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