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General NPI Number Information
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NPI Number | 1952106973
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Entity Type | Organization
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Legal Business Name | KISA HEALTH PLLC
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Dates
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Enumeration Date | 02/14/2025
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 1130 COTTONWOOD CREEK TRL STE B2
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City | CEDAR PARK
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State | TX
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Zip | 78613-7862
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Country | US
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Telephone | 512-553-1771
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Fax |
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Provider Business Mailing Address
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Address Line | 1130 COTTONWOOD CREEK TRL STE B2
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City | CEDAR PARK
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State | TX
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Zip | 78613-7862
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Country | US
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Telephone | 512-553-1771
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN / OWNER
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Name | NAIMEH TASHAKKORINIA
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Credential | MD
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Telephone | 423-227-8382
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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