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General NPI Number Information
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NPI Number | 1902171226
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Entity Type | Organization
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Legal Business Name | NISHA SATISH MD PA
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Dates
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Enumeration Date | 03/20/2012
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Last Update Date | 10/08/2015
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Provider Practice Location Address
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Address Line | 301 DIVISION ST
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City | GREENVILLE
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State | TX
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Zip | 75401-4101
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Country | US
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Telephone | 903-453-3385
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Fax | 972-454-1149
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Provider Business Mailing Address
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Address Line | PO BOX 261092
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City | PLANO
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State | TX
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Zip | 75026-1092
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Country | US
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Telephone | 903-453-3385
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Fax | 972-454-1149
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Authorized Official
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Title or Position | PRESIDENT
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Name | NISHA SATISH
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Credential | MD
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Telephone | 903-453-3385
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | N3290
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License Number State | TX
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