Provider Demographics
NPI:1447227483
Name:KUMAR, NISHI (MD)
Entity type:Individual
Prefix:
First Name:NISHI
Middle Name:
Last Name:KUMAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 AIRPORT FWY STE 220
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-6606
Mailing Address - Country:US
Mailing Address - Phone:817-857-6565
Mailing Address - Fax:817-283-7686
Practice Address - Street 1:1305 AIRPORT FWY STE 220
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021
Practice Address - Country:US
Practice Address - Phone:817-857-6565
Practice Address - Fax:817-283-7686
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT043391207R00000X
TXR5152207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXR5152OtherMEDICAL LICENSE