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Individual

MAHESH CANDIAH THIAGARAJAH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
500 W MAIN ST, LEWISVILLE, TX 75057-3629
(972) 420-1000
Mailing address
5555 E MOCKINGBIRD LN, 1108, DALLAS, TX 75206-5364
(214) 217-1911

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
L9928
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
174068002
TX
05
174068003
TX
05
174068004
TX
01
8W0730
BCBS
TX
01
8W1782
BCBS
TX
01
P00364150
RAILROAD
TX
Enumeration date
06/19/2006
Last updated
07/19/2024
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