MEDICARE: VIJAY AAROHA KANDULA

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1912645581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIJAY AAROHA KANDULA

Provider Business Mailing Address
First Line	:	25611 WHITEHAVEN GATE ST
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77493-4615
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 UNIVERSITY BLVD STE 500
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78665-1360
Country	:	US
Telephone Number	:	512-509-3412
Fax Number	:

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

Provider Enumeration Date	:	05/24/2022
Last Update Date	:	05/27/2026

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Directions to “ VIJAY AAROHA KANDULA ” Practice Location

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