Provider Demographics
NPI:1689188484
Name:NARENDRAN, SARADA DEVI
Entity Type:Individual
Prefix:
First Name:SARADA DEVI
Middle Name:
Last Name:NARENDRAN
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 1:9313 SALISBURY AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-5023
Mailing Address - Country:US
Mailing Address - Phone:806-441-2204
Mailing Address - Fax:
Practice Address - Street 1:9313 SALISBURY AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-5023
Practice Address - Country:US
Practice Address - Phone:806-441-2204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-01
Last Update Date:2017-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6990208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics