Individual provider Active NPI

Soumia Nonesupplied Vijayan, MBBS

  • Internal Medicine Physician
  • Galveston, TX
National Provider Identifier
1821289018
Registry record updated Aug 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
BP10029242 Issued in TX
Practice address
301 University Blvd
Galveston, TX 77555-0462
Phone
(409) 772-4194
NPI assigned
Aug 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X BP10029242 TX Primary

Addresses

Primary practice location

301 University Blvd
Galveston, TX 77555-0462

Mailing address

23425 SE Black Nugget Rd Apt M202
Issaquah, WA 98029-6974

Other identifiers 1

IdentifierTypeStateIssuer
4664134534OtherMYUTMB 4664134534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110426000640 TX Practitioner - Internal Medicine 1951586502 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Texas PLLCGroup PAC ID 3476688318, 685 clinicians

Practice addresses (Care Compare)

8200 Walnut Hill LN
Presbyterian Hospital Dallas
Dallas, TX 75231-4426
Phone (214) 345-6789

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
BP10029242TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrity MD PLLC Internal Medicine CurrentSince Nov 1, 2024 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Jan 15, 2024 Accepting new patients
Star MD of Arlington PLLC Internal Medicine CurrentSince Dec 2, 2023 Accepting new patients
Texas Health Presbyterian Hospital Dallas Past Accepting new patients
Lonestar Hospital Medicine Associates, PA Internal Medicine Past Accepting new patients

Locations

8200 Walnut Hill Ln
Dallas, TX 75231
Phone (214) 345-6148

9 Medical Pkwy
Dallas, TX 75234
Phone (972) 243-5558

9440 Poppy Dr
Dallas, TX 75218
Phone (214) 324-6100

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

1011 N Galloway Ave
Mesquite, TX 75149
Phone (214) 320-7000

Interoperability endpoints

  • FHIR API: https://epproxy.texashealth.org/FHIR/api/FHIR/DSTU2/

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186272000000",
    "number": "1821289018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23425 SE BLACK NUGGET RD APT M202",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980296974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775550462",
            "telephone_number": "409-772-4194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIJAYAN",
        "first_name": "SOUMIA",
        "middle_name": "NONESUPPLIED",
        "name_prefix": "Dr.",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10029242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MYUTMB 4664134534",
            "identifier": "4664134534",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

Verify at the official NPI Registry.