1487692562 NPI number — MRS. NIPA PRASHANT KAMDAR FNP MSN

Table of content: MRS. NIPA PRASHANT KAMDAR FNP MSN (NPI 1487692562)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487692562 NPI number — MRS. NIPA PRASHANT KAMDAR FNP MSN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAMDAR
Provider First Name:
NIPA
Provider Middle Name:
PRASHANT
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP MSN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KINARIWALA
Provider Other First Name:
NIPA
Provider Other Middle Name:
SATISH
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
FNP-C
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1487692562
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/15/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
919 HIDDEN RDG
Provider Second Line Business Mailing Address:
6TH FLOOR
Provider Business Mailing Address City Name:
IRVING
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75038-3813
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
469-282-2625
Provider Business Mailing Address Fax Number:
469-282-2655

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2120 S. WAYSIDE
Provider Second Line Business Practice Location Address:
STE B
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77023-3900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-803-1840
Provider Business Practice Location Address Fax Number:
713-938-5852
Provider Enumeration Date:
06/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  749395 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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