Healthcare Provider Details

I. General information

NPI: 1598122731
Provider Name (Legal Business Name): NAZISH DHUKKA FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NAZIS ALI

II. Dates (important events)

Enumeration Date: 01/19/2016
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 OAKWOOD BLVD STE 125
ROUND ROCK TX
78681-4068
US

IV. Provider business mailing address

15808 RR 620 N STE 100
AUSTIN TX
78717-4923
US

V. Phone/Fax

Practice location:
  • Phone: 855-481-8375
  • Fax:
Mailing address:
  • Phone: 512-324-4850
  • Fax: 512-324-4855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF1015641
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: