Provider Demographics
NPI:1588212674
Name:ASADI, NADIA K
Entity Type:Individual
Prefix:
First Name:NADIA
Middle Name:K
Last Name:ASADI
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 1:19221 I 45 S STE 430
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77385-8770
Mailing Address - Country:US
Mailing Address - Phone:832-813-5743
Mailing Address - Fax:
Practice Address - Street 1:19221 I 45 S STE 430
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77385-8770
Practice Address - Country:US
Practice Address - Phone:832-813-5743
Practice Address - Fax:832-813-8127
Is Sole Proprietor?:No
Enumeration Date:2019-08-31
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX855962208000000X
TXAP143096363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No208000000XAllopathic & Osteopathic PhysiciansPediatrics