Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | M3100 | TX |
N | 207RI0011X | Interventional Cardiology | M3100 | TX |
N | 207U00000X | Nuclear Medicine Specialist | M3100 | TX |
NPI | 1568466365 |
---|---|
Provider Name | Kedarnath A Vaidya |
First Address | Houston, TX 77210-4248 |
Second Address | The Woodlands, TX 77384-4167 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2005 |
Last Update Date | 14/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00J21A | GROUP MEDICARE (01) | TX |
197962701 | (05) | TX |
H35083 | (02) |