Individual
DR. SHREENIVAS K. VASANAWALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 W VETERANS BLVD, BIG SPRING, TX 79720-5566
(432) 263-7361
Mailing address
901 CAPROCK DR, BIG SPRING, TX 79720-6649
(432) 263-3230
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
128796-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
128796-1
MEDICAL LICENSE
NY
Enumeration date
08/13/2006
Last updated
07/08/2007
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