Healthcare Provider Details

I. General information

NPI: 1871027128
Provider Name (Legal Business Name): ARCHANA APPUKUTTAN NAIR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2017
Last Update Date: 08/11/2023
Certification Date: 08/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2745 VIRGINIA PKWY STE 300
MCKINNEY TX
75071-4915
US

IV. Provider business mailing address

2745 VIRGINIA PKWY STE 300
MCKINNEY TX
75071-4915
US

V. Phone/Fax

Practice location:
  • Phone: 469-343-4231
  • Fax:
Mailing address:
  • Phone: 469-343-4231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number62969
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberU1093
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: