Provider Demographics
NPI:1588266605
Name:VAYU ADVANCED WOUND CLINIC AND HYPERBARICS PLLC
Entity type:Organization
Organization Name:VAYU ADVANCED WOUND CLINIC AND HYPERBARICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MANJULATHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BADAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD, CWSP, UHM
Authorized Official - Phone:210-651-1112
Mailing Address - Street 1:13423 BLANCO RD # 767
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-2187
Mailing Address - Country:US
Mailing Address - Phone:210-651-1112
Mailing Address - Fax:855-479-2049
Practice Address - Street 1:8666 HUEBNER RD STE 220
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1837
Practice Address - Country:US
Practice Address - Phone:210-651-1112
Practice Address - Fax:855-479-2049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-13
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1417013368OtherNPI