Provider Demographics
NPI:1629010780
Name:NAIR, RADHA P (MD)
Entity Type:Individual
Prefix:MRS
First Name:RADHA
Middle Name:P
Last Name:NAIR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1117 BEDFORD RD
Mailing Address - Street 2:STE B
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-6694
Mailing Address - Country:US
Mailing Address - Phone:817-282-5712
Mailing Address - Fax:817-282-5965
Practice Address - Street 1:1117 BEDFORD RD
Practice Address - Street 2:STE B
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-6694
Practice Address - Country:US
Practice Address - Phone:817-282-5712
Practice Address - Fax:817-282-5965
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG1732207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC19764Medicare UPIN
TX00217GMedicare ID - Type Unspecified