Provider Demographics
NPI:1346868536
Name:KASIRAJA, SENTHILNAYAKI
Entity Type:Individual
Prefix:
First Name:SENTHILNAYAKI
Middle Name:
Last Name:KASIRAJA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21319 WILD JASMINE LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-5452
Mailing Address - Country:US
Mailing Address - Phone:407-403-0967
Mailing Address - Fax:
Practice Address - Street 1:30575 KINGSLAND BLVD # 150
Practice Address - Street 2:
Practice Address - City:BROOKSHIRE
Practice Address - State:TX
Practice Address - Zip Code:77423-2844
Practice Address - Country:US
Practice Address - Phone:281-717-4674
Practice Address - Fax:833-318-0533
Is Sole Proprietor?:No
Enumeration Date:2020-07-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1003027363L00000X, 207Q00000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine