Individual
DR. PREMALATHA VINDHYA
Active
Individual
DR. PREMALATHA VINDHYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G7739
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G812
BLUE CROSS
TX
05
—
033527501
—
TX
01
—
070006346
RAILROAD MEDICARE
TX
01
—
126180100
FIRST CARE
TX
01
—
45 21 529
AETNA
TX
01
—
72145673
WAUSAU
TX
01
—
820060
CENTRAL STATES SOUTHEAST
TX
01
—
G7739
STATE LICENSE
TX
01
—
N59U
STATE FARM
TX
Enumeration date
05/20/2006
Last updated
07/12/2016
Update your record
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