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NPI Code Detail

MEDICARE: NISHA KAROTTEDATH

MEDICARE: NISHA KAROTTEDATH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner1018974TX

General Provider Information

NPI Number : 1508713884
Entity Type Code : Individual
Provider Name (Legal Business Name) : NISHA KAROTTEDATH
Provider Business Mailing Address
First Line : 17403 MARIGOLD DR
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-3067
Country : US
Telephone Number : 407-617-8821
Fax Number :
Provider Business Practice Location Address
First Line : 6621 FANNIN ST
Second Line :
City : HOUSTON
State : TX
Zip : 77030-2358
Country : US
Telephone Number : 832-824-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2026
Last Update Date : 03/14/2026

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Directions to “ NISHA KAROTTEDATH ” Practice Location

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