Healthcare Provider Details

I. General information

NPI: 1801861117
Provider Name (Legal Business Name): NIRMALA KAMNANI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 07/12/2023
Certification Date: 07/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 E 30TH AVE
PAMPA TX
79065-2822
US

IV. Provider business mailing address

104 E 30TH AVE
PAMPA TX
79065-2822
US

V. Phone/Fax

Practice location:
  • Phone: 806-665-7394
  • Fax: 806-665-0115
Mailing address:
  • Phone: 806-665-7394
  • Fax: 806-665-0115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberH5286
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberH5286
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: