Individual
DR. SANDIP VIJAYSHANKAR MATHUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6300 REGIONAL PLZ, SUITE 820, ABILENE, TX 79606-5251
(325) 692-3777
(325) 695-2659
Mailing address
PO BOX 5496, ABILENE, TX 79608-5496
(325) 692-3777
(325) 695-2659
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
J7076
TX
207RG0100X
Gastroenterology Physician
Primary
J7076
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110648604
—
TX
01
—
118749104
FIRSTCARE
TX
01
—
8AJ206
BCBS
TN
01
—
A002
TRICARE
TX
Enumeration date
06/21/2006
Last updated
07/23/2008
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