# A.SHANMUGAM M.D

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508226234
- **Authorized official:** DR. AIYANADAR SHANMUGAM M.D (PHYSICIAN/OWNER)
- **Authorized official phone:** (979) 696-5663

## Contact information

- **Practice address:** 1602 ROCK PRAIRIE RD, SUITE 210, COLLEGE STATION, TX 77845-8306
- **Practice address phone:** (979) 696-5663
- **Practice address fax:** (979) 694-1319
- **Mailing address:** 1602 ROCK PRAIRIE RD, SUITE 210, COLLEGE STATION, TX 77845-8306
- **Mailing address phone:** (979) 696-5663
- **Mailing address fax:** (979) 694-1319

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | G0539 | TX | Yes |

## Other

- **Enumeration date:** 02/23/2016
- **Last updated:** 02/23/2016