Active NPI
Shreenivas K. Vasanawala, M.D.
- Surgery Physician
- Big Spring, TX
National Provider Identifier
1710999214
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 128796-1
- Practice address
- 300 W Veterans Blvd
Big Spring, TX 79720-5566 - Phone
- (432) 263-7361
- NPI assigned
- Aug 13, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 128796-1 | NY | Primary |
Addresses
Primary practice location
300 W Veterans Blvd
Big Spring, TX 79720-5566
Mailing address
901 Caprock Dr
Big Spring, TX 79720-6649
Phone (432) 263-3230
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 128796-1 | Other | NY | MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 128796-1 | NY | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710999214",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 CAPROCK DR",
"city": "BIG SPRING",
"state": "TX",
"postal_code": "797206649",
"telephone_number": "432-263-3230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W VETERANS BLVD",
"city": "BIG SPRING",
"state": "TX",
"postal_code": "797205566",
"telephone_number": "432-263-7361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VASANAWALA",
"first_name": "SHREENIVAS",
"middle_name": "K.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NY",
"license": "128796-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "128796-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Big Spring, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.