Provider Demographics
NPI:1285816454
Name:IMRAN NATHANI ,M.D. P.A.
Entity Type:Organization
Organization Name:IMRAN NATHANI ,M.D. P.A.
Other - Org Name:FAMILY DIAGNOSTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IMRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NATHANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-351-6800
Mailing Address - Street 1:27721 TOMBALL PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-6561
Mailing Address - Country:US
Mailing Address - Phone:281-351-6800
Mailing Address - Fax:281-516-9020
Practice Address - Street 1:27721 TOMBALL PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-6561
Practice Address - Country:US
Practice Address - Phone:281-351-6800
Practice Address - Fax:281-516-9020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX152709502Medicaid
TXDB4553OtherRAILROAD MEDICARE
TXDB4553OtherRAILROAD MEDICARE