Provider Demographics
NPI:1841962370
Name:KUDCHIWALA, SANA SALEEM (FNP-C, RN)
Entity type:Individual
Prefix:
First Name:SANA
Middle Name:SALEEM
Last Name:KUDCHIWALA
Suffix:
Gender:F
Credentials:FNP-C, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3930 AMALFI SHORES CT
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-7133
Mailing Address - Country:US
Mailing Address - Phone:832-744-5453
Mailing Address - Fax:
Practice Address - Street 1:4002 BURKE RD STE 200
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-3451
Practice Address - Country:US
Practice Address - Phone:832-744-5453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-04
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1055122363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily