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Individual

VARADENDRA B PANCHAMUKHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4510 MEDICAL CENTER DR STE 108, MCKINNEY, TX 75069-1624
(214) 726-9292
(214) 361-3431
Mailing address
8440 WALNUT HILL LN STE 700, DALLAS, TX 75231-3824
(214) 361-3300
(214) 361-3353

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
036-100960
IL
207RC0000X
Cardiovascular Disease Physician
036100960
IL
207RI0011X
Interventional Cardiology Physician
Primary
036100960
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036100960
IL
01
060070688
RAILROAD
IL
Enumeration date
10/19/2006
Last updated
01/04/2022
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