Provider Demographics
NPI:1366778540
Name:ACHARYA, MANDEEP (MD)
Entity type:Individual
Prefix:DR
First Name:MANDEEP
Middle Name:
Last Name:ACHARYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9191 KYSER WAY STE 205
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-2783
Mailing Address - Country:US
Mailing Address - Phone:972-643-8727
Mailing Address - Fax:972-643-8728
Practice Address - Street 1:9191 KYSER WAY STE 205
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-2783
Practice Address - Country:US
Practice Address - Phone:972-643-8727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-23
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125056161207R00000X
TXP2937208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist