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Dr. Aiyanadar Shanmugam, MDFACE,FACE
Specialist in College Station, Texas
NPI 1386659811

Aiyanadar Shanmugam is a Specialist based in College Station, TX. Aiyanadar Shanmugam practices in College Station, TX and has the professional credentials of MDFACE,FACE. The NPI Number for Aiyanadar Shanmugam is 1386659811 and holds a License No. 74-2273494 (Texas).

The current practice location address for Aiyanadar Shanmugam is 1602 Rock Prairie Rd, College Station, TX and can be reached out via phone at 979-696-5663 and via fax at 979-693-1274.

Location: 1602 Rock Prairie Rd, College Station, TX, 77845-8306
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1386659811
Provider Name
Aiyanadar Shanmugam
Credential
MDFACE,FACE
Provider Entity Type
Individual
Gender
Male
Address
1602 Rock Prairie Rd, College Station, TX, 77845-8306
Phone Number
979-696-5663
Fax Number
979-693-1274
Provider Enumeration Date
07/31/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
110539701 05 TX
00AQ85 01 TX BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
1602 Rock Prairie Rd
City
College Station
State
Texas
Zip
77845-8306
Phone Number
979-696-5663
Fax Number
979-693-1274
person
Provider Business Mailing Address Details
Address
1602 Rock Prairie Rd
City
College Station
State
Texas
Zip
77845-8306
Phone Number
979-696-5663
Fax Number
979-693-1274
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
74-2273494 (Texas)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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