=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316395478
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AASHNA HANDA D.D.S
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/31/2016
-----------------------------------------------------
Last Update Date | 05/31/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 19690 INTERSTATE 35 S
-----------------------------------------------------
City | LYTLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78052-3492
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 830-772-5600
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 303 INNSDALE TER APT # D
-----------------------------------------------------
City | CLOVIS
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 88101-3025
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 213-290-8161
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223P0221X
-----------------------------------------------------
Taxonomy Name | Pediatric Dentistry
-----------------------------------------------------
License Number | 31833
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------