Manohar Vajja, MD PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

M7714 Issued in TX

Legal business name

MANOHAR VAJJA, MD PA

Practice address

6447 Malaga
Irving, TX 75039-3191

Phone

(972) 910-9341

Fax

(972) 499-2500

NPI assigned

May 3, 2011

Organization subpart

No

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

Authorized official

Name

Manohar Prasad Vajja, MDNPI 1306048277

Title

President

Phone

(972) 910-9341

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Manohar P Vajja, MD

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1306048277
  Medicare reassignment NPD Authorized official
• Melissa Stoup, APRN, FNP-C

  • Family Nurse Practitioner
  • Waxahachie, TX
  • NPI 1467003855
  Medicare reassignment NPD

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

{
    "created_epoch": "1304380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315526400000",
    "number": "1790077279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6447 MALAGA",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750393191",
            "telephone_number": "972-910-9341",
            "fax_number": "972-499-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6447 MALAGA",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750393191",
            "telephone_number": "972-910-9341",
            "fax_number": "972-499-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANOHAR VAJJA, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-03",
        "last_updated": "2011-09-09",
        "status": "A",
        "authorized_official_last_name": "VAJJA",
        "authorized_official_first_name": "MANOHAR",
        "authorized_official_middle_name": "PRASAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-910-9341",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M7714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "TXB130027",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCE",
            "identifier": "M7714",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Mann, APRN, CRNA
• Travis Matthew Mann, D.C
• Natasha Mannan
• Abbey Grace Manning, SLPA
• Emma Lambertus Manning, CRNA
• Maribel Manriquez, D.C.
• Gabriela Castaneda Mansfield, CRNA
• Jena Mansour
• Manuel C Pecana MD PLLC
• Manuel C.Pecana,M.D.P.a.

• Internal Medicine Physician in Irving, TX
• Providers in Irving, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2011; 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.