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Organization
VIJAYALAKSHMI NANDIMANDALAM, M.D., P.A.
Active
Organization
VIJAYALAKSHMI NANDIMANDALAM, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BECKY BLEVINS (OFFICE MANAGER)
(903) 640-4700
Entity
Organization
Contact information
Practice address
1211 E 6TH ST, SUITE 100, BONHAM, TX 75418-4095
(903) 640-4700
(903) 640-1975
Mailing address
1211 E 6TH ST, SUITE 100, BONHAM, TX 75418-4095
(903) 640-4700
(903) 640-1975
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M5849
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195422401
—
TX
Enumeration date
08/21/2007
Last updated
01/03/2011
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