Provider Demographics
NPI:1487038659
Name:VAITHILINGAM, SIDDHARTHAN (MD, DAABIP)
Entity type:Individual
Prefix:DR
First Name:SIDDHARTHAN
Middle Name:
Last Name:VAITHILINGAM
Suffix:
Gender:M
Credentials:MD, DAABIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3410 WORTH ST STE 250
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-2073
Mailing Address - Country:US
Mailing Address - Phone:214-820-6856
Mailing Address - Fax:214-820-1638
Practice Address - Street 1:3410 WORTH ST STE 250
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2073
Practice Address - Country:US
Practice Address - Phone:214-820-6856
Practice Address - Fax:214-820-1638
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU6361207R00000X, 207RC0200X, 207RP1001X
ARE-15039207RP1001X
IL036-144127207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine