Provider Demographics
NPI:1629034640
Name:NAGDA, RABIA M (MD)
Entity Type:Individual
Prefix:DR
First Name:RABIA
Middle Name:M
Last Name:NAGDA
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 1:418 PARK GROVE LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-1571
Mailing Address - Country:US
Mailing Address - Phone:281-492-0774
Mailing Address - Fax:
Practice Address - Street 1:418 PARK GROVE LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450
Practice Address - Country:US
Practice Address - Phone:281-492-0774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0430589208000000X
TXM0836208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200256700BMedicaid
269D046Medicare ID - Type Unspecified
KS200256700BMedicaid