Individual
DR. VIVEK MAHENDRU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4100 DUVAL RD BLDG III, SUITE 200, AUSTIN, TX 78759-4275
(512) 485-7200
(512) 485-7220
Mailing address
4100 DUVAL RD BLDG III, SUITE 200, AUSTIN, TX 78759-4275
(512) 485-7200
(512) 485-7220
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
J7566
TX
208VP0014X
Interventional Pain Medicine Physician
Primary
J7566
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
84X790
BCBS
TX
Enumeration date
06/10/2006
Last updated
10/26/2017
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