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General NPI Number Information
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NPI Number | 1124382122
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Entity Type | Individual
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Provider Name | ARCHANA DAVE DO
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Gender | Female
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Dates
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Enumeration Date | 06/25/2012
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 6621 FANNIN ST
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City | HOUSTON
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State | TX
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Zip | 77030-2358
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Country | US
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Telephone | 832-824-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 3305 CANNONGATE RD APT 102
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City | FAIRFAX
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State | VA
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Zip | 22031-4805
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Country | US
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Telephone | 832-816-8608
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0116024805
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | Q4745
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License Number State | TX
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