Vijayalakshmi Nandimandalam, M.D., P.a.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

M5849 Issued in TX

Legal business name

VIJAYALAKSHMI NANDIMANDALAM, M.D., P.A.

Practice address

1211 E 6TH St
Suite 100
Bonham, TX 75418-4095

Phone

(903) 640-4700

Fax

(903) 640-1975

NPI assigned

Aug 21, 2007

Organization subpart

No

Name

Becky Blevins

Title

Office Manager

Phone

(903) 640-4700

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 3, 2011.

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294012800000",
    "number": "1023201241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 E 6TH ST",
            "address_2": "SUITE 100",
            "city": "BONHAM",
            "state": "TX",
            "postal_code": "754184095",
            "telephone_number": "903-640-4700",
            "fax_number": "903-640-1975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 E 6TH ST",
            "address_2": "SUITE 100",
            "city": "BONHAM",
            "state": "TX",
            "postal_code": "754184095",
            "telephone_number": "903-640-4700",
            "fax_number": "903-640-1975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIJAYALAKSHMI NANDIMANDALAM, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-21",
        "last_updated": "2011-01-03",
        "status": "A",
        "authorized_official_last_name": "BLEVINS",
        "authorized_official_first_name": "BECKY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "903-640-4700"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M5849",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195422401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Bonham, TX
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.