Provider Demographics
NPI:1346861770
Name:NISHIKAWA, CHISATO (MD)
Entity Type:Individual
Prefix:
First Name:CHISATO
Middle Name:
Last Name:NISHIKAWA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10745 W GRAND PKWY S STE 200
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-8713
Mailing Address - Country:US
Mailing Address - Phone:281-275-0130
Mailing Address - Fax:
Practice Address - Street 1:10745 W GRAND PKWY S
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-8711
Practice Address - Country:US
Practice Address - Phone:281-275-0130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-27
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU4289207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine