Individual
MAIA VANDYKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5323 HARRY HINES BLVD, DEPARTMENT OF SURGERY, DALLAS, TX 75390-7201
(214) 590-8058
Mailing address
5323 HARRY HINES BLVD, DEPARTMENT OF SURGERY, DALLAS, TX 75390-7201
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
T4603
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/11/2017
Last updated
07/07/2022
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