Healthcare Provider Details

I. General information

NPI: 1477714871
Provider Name (Legal Business Name): NADYA MAWJEE DHANANI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2008
Last Update Date: 02/12/2020
Certification Date: 02/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 FANNIN ST STE. 2150
HOUSTON TX
77030-1521
US

IV. Provider business mailing address

6400 FANNIN ST STE 2070
HOUSTON TX
77030-1541
US

V. Phone/Fax

Practice location:
  • Phone: 713-486-8100
  • Fax: 713-486-8101
Mailing address:
  • Phone: 713-486-7747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number250991
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberQ0428
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberMT193256
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberQ0428
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: