Provider Demographics
NPI:1750831053
Name:ARDESHNA, NIDHI (PT)
Entity Type:Individual
Prefix:
First Name:NIDHI
Middle Name:
Last Name:ARDESHNA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 SUNDOWN BLVD
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-8032
Mailing Address - Country:US
Mailing Address - Phone:940-387-3700
Mailing Address - Fax:
Practice Address - Street 1:612 N BEDELL AVE STE D
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-4173
Practice Address - Country:US
Practice Address - Phone:830-488-6265
Practice Address - Fax:830-488-6269
Is Sole Proprietor?:No
Enumeration Date:2016-10-11
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1273915225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist