Provider Demographics
NPI:1538636402
Name:NIKTABE, NAVID SR
Entity Type:Individual
Prefix:
First Name:NAVID
Middle Name:
Last Name:NIKTABE
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6535 SOUTHWEST FWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-2207
Mailing Address - Country:US
Mailing Address - Phone:713-981-8184
Mailing Address - Fax:713-981-8118
Practice Address - Street 1:6535 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-2207
Practice Address - Country:US
Practice Address - Phone:713-981-8184
Practice Address - Fax:713-981-8118
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13918111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty