Provider Demographics
NPI:1730652538
Name:NAIR, SHEENA PREJITH
Entity Type:Individual
Prefix:
First Name:SHEENA
Middle Name:PREJITH
Last Name:NAIR
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 1:1710 HUMBOLT DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-6457
Mailing Address - Country:US
Mailing Address - Phone:214-650-3047
Mailing Address - Fax:
Practice Address - Street 1:3453 SAINT FRANCIS AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-7199
Practice Address - Country:US
Practice Address - Phone:214-660-1833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-04
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133759363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily