Provider Demographics
NPI:1669888434
Name:DESNAK
Entity type:Organization
Organization Name:DESNAK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NALINI
Authorized Official - Middle Name:
Authorized Official - Last Name:NAIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-400-4011
Mailing Address - Street 1:2311 TEXAS DR
Mailing Address - Street 2:SUITE#106
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-7071
Mailing Address - Country:US
Mailing Address - Phone:214-400-4011
Mailing Address - Fax:
Practice Address - Street 1:2311 TEXAS DR
Practice Address - Street 2:SUITE#106
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-7071
Practice Address - Country:US
Practice Address - Phone:214-400-4011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-01
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6988305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD67954Medicare UPIN