Individual
DR. VIJAY KRISHNAN MOHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
104 E 30TH, PAMPA, TX 79065
(806) 669-3303
(806) 669-6611
Mailing address
104 E 30TH, PAMPA, TX 79065
(806) 669-3303
(806) 669-6611
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
F2358
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115014603
—
TX
01
—
224950
BCBS
TX
01
—
4530275
AETNA
TX
Enumeration date
10/04/2006
Last updated
02/01/2010
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