Individual
DR. JITENDRA I VASANDANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10705 MILWAUKEE AVENUE, LUBBOCK, TX 78424
(806) 701-5210
Mailing address
10705 MILWAUKEE AVE, LUBBOCK, TX 79424-6153
(806) 744-7223
(806) 740-3325
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
K9691
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00680R
BCBS GROUP
TX
05
—
040221603
—
TX
01
—
100264101
FIRSTCARE
TX
01
—
4637990001
MEDICARE NSC
TX
01
—
8445N3
BCBS
TX
01
—
CJ4139
RAILROAD MEDICARE
TX
Enumeration date
11/14/2005
Last updated
03/01/2023
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