Provider Demographics
NPI:1396165213
Name:CHANDWANI, VINITA DAYAL (MD)
Entity type:Individual
Prefix:
First Name:VINITA
Middle Name:DAYAL
Last Name:CHANDWANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:VINITA
Other - Middle Name:CHANDWANI
Other - Last Name:VIGNESWARAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:5340 WESLAYAN ST # 273342
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-1048
Mailing Address - Country:US
Mailing Address - Phone:281-467-3858
Mailing Address - Fax:
Practice Address - Street 1:1405 CLIFTON RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-4311
Practice Address - Country:US
Practice Address - Phone:281-467-3858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-17
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU1872208000000X
GA1396165213208000000X
GA78399208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty