Provider Demographics
NPI:1639610538
Name:NIRVANA CARE PLLC
Entity Type:Organization
Organization Name:NIRVANA CARE PLLC
Other - Org Name:BROOK HOLLOW FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:VIRENDRASINH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAUHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-494-7681
Mailing Address - Street 1:15068 SAN PEDRO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-3714
Mailing Address - Country:US
Mailing Address - Phone:210-494-7681
Mailing Address - Fax:
Practice Address - Street 1:15068 SAN PEDRO AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-3714
Practice Address - Country:US
Practice Address - Phone:210-494-7681
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-13
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29133122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty