Provider Demographics
NPI: | 1306890835 |
---|---|
Name: | VARWANI, MUSA G (MD) |
Entity type: | Individual |
Prefix: | |
First Name: | MUSA |
Middle Name: | G |
Last Name: | VARWANI |
Suffix: | |
Gender: | M |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 8200 WALNUT HILL LN STE 830 |
Mailing Address - Street 2: | |
Mailing Address - City: | DALLAS |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75231-4426 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 214-345-7999 |
Mailing Address - Fax: | 214-345-7942 |
Practice Address - Street 1: | 8200 WALNUT HILL LN STE 830 |
Practice Address - Street 2: | |
Practice Address - City: | DALLAS |
Practice Address - State: | TX |
Practice Address - Zip Code: | 75231-4426 |
Practice Address - Country: | US |
Practice Address - Phone: | 214-345-7999 |
Practice Address - Fax: | 214-345-7942 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-05-20 |
Last Update Date: | 2018-03-26 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | M3103 | 207R00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
TX | 181902101 | Medicaid | |
TX | 181902102 | Medicaid | |
TX | 8V2356 | Other | BCBSTX |
TX | 330060YMR3 | Medicare PIN | |
TX | 8V2356 | Other | BCBSTX |
TX | 181902101 | Medicaid | |
TX | 8G6746 | Medicare PIN | |
H32976 | Medicare UPIN |