Healthcare Provider Details

I. General information

NPI: 1942299367
Provider Name (Legal Business Name): NARGIS HUSAINY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 01/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 E 11TH ST
LIBERAL KS
67901-2720
US

IV. Provider business mailing address

23 E 11TH ST
LIBERAL KS
67901-2720
US

V. Phone/Fax

Practice location:
  • Phone: 620-624-5066
  • Fax: 620-624-2872
Mailing address:
  • Phone: 620-624-5066
  • Fax: 620-624-2872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number045503
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberTP689
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0433384
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: