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Organization
VIJAYA NAMA M.D PA
Active
Organization
VIJAYA NAMA M.D PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIJAYA NAMA M.D (DIRECTOR)
(972) 613-2127
Entity
Organization
Contact information
Practice address
5115 N GALLOWAY AVE STE 304, MESQUITE, TX 75150-7535
(972) 613-2127
(972) 613-2726
Mailing address
PO BOX 851484, MESQUITE, TX 75185-1484
(972) 613-2127
(972) 613-2726
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L7821
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
187640101
—
TX
Enumeration date
09/25/2007
Last updated
01/27/2012
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