Basic Information
| Provider Information | |||||||||
| NPI: | 1750831053 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ARDESHNA | ||||||||
| FirstName: | NIDHI | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3301 SUNDOWN BLVD | ||||||||
| Address2: | |||||||||
| City: | DENTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 762108032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9403873700 | ||||||||
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| Practice Location | |||||||||
| Address1: | 612 N BEDELL AVE STE D | ||||||||
| Address2: | |||||||||
| City: | DEL RIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 788404173 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8304886265 | ||||||||
| FaxNumber: | 8304886269 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/11/2016 | ||||||||
| LastUpdateDate: | 07/15/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 1273915 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.