Provider Demographics
NPI:1316226293
Name:NATHWANI, DHARNI JENIL
Entity Type:Individual
Prefix:
First Name:DHARNI
Middle Name:JENIL
Last Name:NATHWANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DHARNI
Other - Middle Name:LAKSHMAN
Other - Last Name:DUTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:730 COTTONWOOD BEND DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-5202
Mailing Address - Country:US
Mailing Address - Phone:248-275-6100
Mailing Address - Fax:
Practice Address - Street 1:6105 WINDCOM CT STE 300
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-7821
Practice Address - Country:US
Practice Address - Phone:972-781-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-10
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40099225100000X
MI5501015571225100000X
TX1355614225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist