Basic Information
| Provider Information | |||||||||
| NPI: | 1912537234 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NIRAULA | ||||||||
| FirstName: | PRABHA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 26914 RIVERBEND POINT LN | ||||||||
| Address2: | |||||||||
| City: | CYPRESS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774336534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5107176068 | ||||||||
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| Practice Location | |||||||||
| Address1: | 509 W TIDWELL RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770914353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7136946447 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2020 | ||||||||
| LastUpdateDate: | 12/08/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/08/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 860248 | TX | N | Nursing Service Providers | Registered Nurse | 363LF0000X | 1012454 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.