1720795115 NPI number — DHANVI'S HEALTH CARE LLC

Table of content: (NPI 1720795115)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720795115 NPI number — DHANVI'S HEALTH CARE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DHANVI'S HEALTH CARE LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720795115
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/03/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7350 MCARDLE RD APT 37
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORPUS CHRISTI
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78412-4231
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
361-345-4656
Provider Business Mailing Address Fax Number:
361-345-4647

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
611 S HWY 359
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MATHIS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78368-3005
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-345-4656
Provider Business Practice Location Address Fax Number:
361-345-4647
Provider Enumeration Date:
11/03/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MANDADI
Authorized Official First Name:
RAMANA
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGING OFFICER
Authorized Official Telephone Number:
361-345-4656

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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