Provider Demographics
NPI:1649682105
Name:NAIR, BRINDA
Entity type:Individual
Prefix:
First Name:BRINDA
Middle Name:
Last Name:NAIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRINDA
Other - Middle Name:
Other - Last Name:NAIR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:109 SUNRISE RIDGE CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78738-5613
Mailing Address - Country:US
Mailing Address - Phone:210-483-0661
Mailing Address - Fax:
Practice Address - Street 1:5717 S IH 35 STE 101
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78744-2711
Practice Address - Country:US
Practice Address - Phone:512-462-4775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX299131223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice