Provider Demographics
NPI:1124096375
Name:THOPPIL, NIMMI TERESA (MD)
Entity type:Individual
Prefix:DR
First Name:NIMMI
Middle Name:TERESA
Last Name:THOPPIL
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 1:1210 W BRAKER LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-3801
Mailing Address - Country:US
Mailing Address - Phone:512-978-9300
Mailing Address - Fax:512-279-2556
Practice Address - Street 1:1210 W BRAKER LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-3801
Practice Address - Country:US
Practice Address - Phone:512-978-9300
Practice Address - Fax:512-279-2556
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11550208000000X
TXN0504208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
I46874Medicare UPIN
NV100508077Medicaid
NV101775Medicare PIN