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NPI Code Detail

MEDICARE: DR. PARTHA MANDAL D.O.

MEDICARE: DR. PARTHA MANDAL D.O.
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
12085R0202XDiagnostic Radiology PhysicianR8782TX
2390200000XStudent in an Organized Health Care Education/Training ProgramBP10052395TX
32085R0204XVascular & Interventional Radiology PhysicianR8782TX

General Provider Information

NPI Number : 1952798084
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PARTHA MANDAL D.O.
Provider Business Mailing Address
First Line : 1607 N MAIN ST
Second Line :
City : VICTORIA
State : TX
Zip : 77901-5213
Country : US
Telephone Number : 409-651-3476
Fax Number : 713-426-4015
Provider Business Practice Location Address
First Line : 2701 HOSPITAL DR
Second Line :
City : VICTORIA
State : TX
Zip : 77901-5749
Country : US
Telephone Number : 361-573-9181
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2015
Last Update Date : 06/15/2021

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