Provider Demographics
NPI:1295477735
Name:NEGANDHI, NILAM S (OTR)
Entity type:Individual
Prefix:MS
First Name:NILAM
Middle Name:S
Last Name:NEGANDHI
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MS
Other - First Name:NILAM
Other - Middle Name:S
Other - Last Name:BHATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3804 CAMINO DRIVE
Mailing Address - Street 2:PLANO
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074
Mailing Address - Country:US
Mailing Address - Phone:469-323-6942
Mailing Address - Fax:
Practice Address - Street 1:3804 CAMINO DRIVE
Practice Address - Street 2:PLANO
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074
Practice Address - Country:US
Practice Address - Phone:469-323-6942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107087208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty