Healthcare Provider Details

I. General information

NPI: 1912164625
Provider Name (Legal Business Name): SMRITI KANA GOSWAMI WHCNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 06/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 N BRITAIN RD IRVING WOMEN'S HEALTH CENTER
IRVING TX
75061-2630
US

IV. Provider business mailing address

PO BOX 660599
DALLAS TX
75266-0599
US

V. Phone/Fax

Practice location:
  • Phone: 214-266-3204
  • Fax:
Mailing address:
  • Phone: 214-590-4105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number673038
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: