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General NPI Number Information
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NPI Number | 1821299058
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Entity Type | Individual
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Provider Name | RAJAN NANDA D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 05/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 14535 MEMORIAL DR
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City | HOUSTON
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State | TX
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Zip | 77079-5428
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Country | US
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Telephone | 713-598-6365
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Fax |
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Provider Business Mailing Address
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Address Line | 9402 HENDON LN
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City | HOUSTON
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State | TX
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Zip | 77036-6024
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Country | US
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Telephone | 713-772-5656
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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 | 16862
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License Number State | TX
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