Individual
VICHIN PURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1411 N. BECKLEY AVE., PAVILION III, SUITE 268, DALLAS, TX 75203-7520
(214) 947-4400
(214) 947-4404
Mailing address
3400 W WHEATLAND RD BLDG 3 # 360, DALLAS, TX 75237
(214) 884-4700
(214) 884-4761
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Primary
R1109
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03977069
—
MS
05
—
201068001
—
AR
01
—
6002233
BCBS
TN
01
—
P01473968
RAILROAD MEDICARE
TN
05
—
Q002437
—
TN
Enumeration date
11/14/2008
Last updated
03/17/2018
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