Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 046155 | CT |
N | 208000000X | Pediatrician | E-11454 | AR |
N | 2080P0202X | Pediatric Cardiologist | E-11454 | AR |
Y | 2080P0203X | Pediatric Critical Care Doctor | S2852 | TX |
NPI | 1114105038 |
---|---|
Provider Name | Upulie Nawaratne |
First Address | Houston, TX 77030-2809 |
Second Address | Houston, TX 77030-1521 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2008 |
Last Update Date | 27/11/2020 |