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General NPI Number Information
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NPI Number | 1649682105
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Entity Type | Individual
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Provider Name | BRINDA NAIR
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Gender | Female
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Dates
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Enumeration Date | 06/02/2014
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Last Update Date | 02/04/2019
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Provider Practice Location Address
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Address Line | 5717 S IH 35 STE 101
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City | AUSTIN
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State | TX
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Zip | 78744-2711
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Country | US
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Telephone | 512-462-4775
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Fax |
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Provider Business Mailing Address
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Address Line | 109 SUNRISE RIDGE CV
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City | AUSTIN
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State | TX
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Zip | 78738-5613
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Country | US
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Telephone | 210-483-0661
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 29913
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 29913
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License Number State | TX
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