Provider Demographics
NPI:1750326658
Name:VASSA, NAYNA MEHTA (PT)
Entity type:Individual
Prefix:
First Name:NAYNA
Middle Name:MEHTA
Last Name:VASSA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6171 VIRGINIA PARKWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5620
Mailing Address - Country:US
Mailing Address - Phone:972-547-4849
Mailing Address - Fax:972-767-2255
Practice Address - Street 1:6171 VIRGINIA PARKWAY
Practice Address - Street 2:
Practice Address - City:MCCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-5620
Practice Address - Country:US
Practice Address - Phone:972-547-4849
Practice Address - Fax:972-767-2255
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1020311174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist