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General NPI Number Information
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NPI Number | 1306112909
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Entity Type | Organization
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Legal Business Name | NISHA AMIN, PHD, PLLC
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Dates
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Enumeration Date | 03/28/2012
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Last Update Date | 03/28/2012
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Provider Practice Location Address
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Address Line | 4909 HIGHWAY 69 S
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City | BEAUMONT
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State | TX
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Zip | 77705-1244
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Country | US
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Telephone | 409-724-0370
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Fax | 409-724-0375
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Provider Business Mailing Address
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Address Line | 4909 HIGHWAY 69 S
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City | BEAUMONT
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State | TX
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Zip | 77705-1244
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Country | US
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Telephone | 409-724-0370
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Fax | 409-724-0375
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Authorized Official
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Title or Position | OWNER
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Name | MS. NISHA MURLIDHAR AMIN
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Credential | PH.D.
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Telephone | 409-724-0370
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 30550
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License Number State | TX
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