Individual
DR. VINAI MODINI MODEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 7TH AVE, FORT WORTH, TX 76104-2733
(682) 885-7942
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-1855
(682) 885-1396
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
M3416
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M3416
TEXAS PHYSICIAN PERMIT
TX
Enumeration date
07/04/2006
Last updated
02/25/2020
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