Provider Demographics
NPI:1114196870
Name:NEKOOI, NADIA (PA)
Entity Type:Individual
Prefix:
First Name:NADIA
Middle Name:
Last Name:NEKOOI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6807 E.F. LOWRY EXPWY STE 103
Mailing Address - Street 2:
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77591
Mailing Address - Country:US
Mailing Address - Phone:409-938-1770
Mailing Address - Fax:409-938-0701
Practice Address - Street 1:6807 E.F. LOWRY EXPWY STE 103
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591
Practice Address - Country:US
Practice Address - Phone:409-938-1770
Practice Address - Fax:409-938-0701
Is Sole Proprietor?:No
Enumeration Date:2008-02-27
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04571363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F9586Medicare PIN