Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 807008 | TX |
NPI | 1023366747 |
---|---|
Provider Name | Kavita Vishal Desai |
First Address | Sherman, TX 75092 |
Second Address | Sherman, TX 75092 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2012 |
Last Update Date | 28/08/2012 |