Provider Demographics
NPI:1619261716
Name:MEHROTRA, NIDHI (MD)
Entity Type:Individual
Prefix:DR
First Name:NIDHI
Middle Name:
Last Name:MEHROTRA
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 1:5151 EDLOE ST
Mailing Address - Street 2:APT. NO. 14203
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-1102
Mailing Address - Country:US
Mailing Address - Phone:831-236-8236
Mailing Address - Fax:
Practice Address - Street 1:3701 KIRBY DR
Practice Address - Street 2:SUITE 600
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-3900
Practice Address - Country:US
Practice Address - Phone:713-798-7790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-06
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10039481207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine