Provider Demographics
NPI:1215042981
Name:THOMAS, NISHANO (DMD)
Entity Type:Individual
Prefix:MRS
First Name:NISHANO
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:NISHANO
Other - Middle Name:
Other - Last Name:CHALUPARAMBIL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:6010 WASHINGTON AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-5015
Mailing Address - Country:US
Mailing Address - Phone:713-864-3800
Mailing Address - Fax:713-864-3882
Practice Address - Street 1:6010 WASHINGTON AVE
Practice Address - Street 2:SUITE D
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-5015
Practice Address - Country:US
Practice Address - Phone:713-864-3800
Practice Address - Fax:713-864-3882
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX215791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice