Provider Demographics
NPI:1952106973
Name:KISA HEALTH PLLC
Entity type:Organization
Organization Name:KISA HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAIMEH
Authorized Official - Middle Name:
Authorized Official - Last Name:TASHAKKORINIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-227-8382
Mailing Address - Street 1:1130 COTTONWOOD CREEK TRL STE B2
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-7862
Mailing Address - Country:US
Mailing Address - Phone:512-553-1771
Mailing Address - Fax:
Practice Address - Street 1:1130 COTTONWOOD CREEK TRL STE B2
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7862
Practice Address - Country:US
Practice Address - Phone:512-553-1771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty