Vijaya Nama MD PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

L7821 Issued in TX

Legal business name

VIJAYA NAMA MD PA

Practice address

407 W Interstate 30
Garland, TX 75043-5912

Phone

(972) 303-3000

Fax

(972) 303-3003

NPI assigned

Aug 2, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Vijaya Nama, M.D.

Title

Owner

Phone

(972) 303-3000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Vijaya Nama M.D PA

  • Family Medicine Physician
  • Mesquite, TX
  • NPI 1770770638

  O20061005000115

  Same enrollment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073520177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 W INTERSTATE 30",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750435912",
            "telephone_number": "972-303-3000",
            "fax_number": "972-303-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 W INTERSTATE 30",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750435912",
            "telephone_number": "972-303-3000",
            "fax_number": "972-303-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIJAYA NAMA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NAMA",
        "authorized_official_first_name": "VIJAYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-303-3000",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TX",
            "license": "L7821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Garland, TX
• Providers in Garland, TX by specialty
• Primary Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.