Healthcare Provider Details

I. General information

NPI: 1881205441
Provider Name (Legal Business Name): MAHERIN DHUKA FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2020
Last Update Date: 04/13/2023
Certification Date: 04/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1332 PIN OAK RD
KATY TX
77494-6848
US

IV. Provider business mailing address

518 SOMERSET DR
SUGAR LAND TX
77479-4450
US

V. Phone/Fax

Practice location:
  • Phone: 713-714-7192
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1003162
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: