Provider Demographics
NPI:1194858415
Name:CKP NAIR, MD PLLC
Entity Type:Organization
Organization Name:CKP NAIR, MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CKP
Authorized Official - Middle Name:
Authorized Official - Last Name:NAIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-877-4105
Mailing Address - Street 1:909 9TH AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-3903
Mailing Address - Country:US
Mailing Address - Phone:817-877-4105
Mailing Address - Fax:817-366-1409
Practice Address - Street 1:909 9TH AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-3903
Practice Address - Country:US
Practice Address - Phone:817-877-4105
Practice Address - Fax:817-366-1409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty