Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | K7357 | TX |
NPI | 1013013192 |
---|---|
Provider Name | Pallavi Nandeeshwar |
First Address | Mckinney, TX 75069-3394 |
Second Address | Mckinney, TX 75069-3394 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 14/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H52814 | (02) | TX |