Provider Demographics
NPI:1730206533
Name:VACHHANI, ASHOKKUMAR NANJI (MD)
Entity type:Individual
Prefix:DR
First Name:ASHOKKUMAR
Middle Name:NANJI
Last Name:VACHHANI
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:PO BOX 100
Mailing Address - Street 2:
Mailing Address - City:NEW WAVERLY
Mailing Address - State:TX
Mailing Address - Zip Code:77358-0100
Mailing Address - Country:US
Mailing Address - Phone:832-724-1122
Mailing Address - Fax:
Practice Address - Street 1:1020 RIVERWOOD CT
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2811
Practice Address - Country:US
Practice Address - Phone:936-521-6300
Practice Address - Fax:936-760-2898
Is Sole Proprietor?:No
Enumeration Date:2007-03-25
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG08532084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC 22886Medicare UPIN
TXSG12Medicare ID - Type Unspecified