Provider Demographics
NPI:1942308804
Name:KOHLI, NANDINI D (MD)
Entity Type:Individual
Prefix:
First Name:NANDINI
Middle Name:D
Last Name:KOHLI
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 1:2200 PARK BEND DR
Mailing Address - Street 2:BLDG. II, SUITE 300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5387
Mailing Address - Country:US
Mailing Address - Phone:512-836-5665
Mailing Address - Fax:512-997-9092
Practice Address - Street 1:2200 PARK BEND DR
Practice Address - Street 2:BLDG II, SUITE 300
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5387
Practice Address - Country:US
Practice Address - Phone:512-836-5665
Practice Address - Fax:512-997-9092
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2969207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE61936Medicare UPIN
TX8066B8Medicare ID - Type Unspecified