MEDICARE: DR. NAHID VANDSHEKARI M.D.

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	251E00000X	Home Health Agency	018430	TX
2	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician	018430	TX
3	207Q00000X	Family Medicine Physician	L5938	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	70126090	OTHER	TX	DPS

General Provider Information

NPI Number	:	1982660759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NAHID VANDSHEKARI M.D.

Provider Business Mailing Address
First Line	:	5555 N MESA ST STE 400
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-5424
Country	:	US
Telephone Number	:	915-320-9476
Fax Number	:	915-275-5510

Provider Business Practice Location Address
First Line	:	5555 N MESA ST STE 400
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-5424
Country	:	US
Telephone Number	:	915-320-9476
Fax Number	:	915-275-5510

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

Provider Enumeration Date	:	04/21/2006
Last Update Date	:	03/04/2024

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