Mohan, Ponnaiah C.

Mohan, Ponnaiah C. is an individual health care provider with primary practice located at 3125 Matlock Rd Ste 107 , Arlington TX 76015-2905. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Mohan, Ponnaiah C. can be contacted via phone (817) 899-8109.

Contact Information

Primary practice address
3125 Matlock Rd Ste 107 Arlington TX 76015-2905
Phone: (817) 899-8109
Fax: (888) 878-5157
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X M1245 Texas

Profile Details

NPI number 1487646295
LBN Legal business name Mohan, Ponnaiah C.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2005
Last updated Jun 21st, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487646295 NPPES
Texas Other 8226BO BLUE CROSS
Texas MEDICAID 173763701 BLUE CROSS
Texas Other P00262936 BLUE CROSS

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