Provider Demographics
NPI:1871801043
Name:NIJANAND LLC
Entity type:Organization
Organization Name:NIJANAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PRITI
Authorized Official - Middle Name:HEMENDRA
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:B S R PH
Authorized Official - Phone:713-988-1104
Mailing Address - Street 1:6700 WEST LOOP S
Mailing Address - Street 2:SUITE 325
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-4104
Mailing Address - Country:US
Mailing Address - Phone:713-988-1104
Mailing Address - Fax:
Practice Address - Street 1:6700 WEST LOOP S
Practice Address - Street 2:SUITE 325
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4104
Practice Address - Country:US
Practice Address - Phone:713-988-1104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-21
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX146292Medicaid