Provider Demographics
NPI:1952595886
Name:NISHA AMIN, PH.D., P.L.L.C
Entity Type:Organization
Organization Name:NISHA AMIN, PH.D., P.L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:409-724-0370
Mailing Address - Street 1:4909 HIGHWAY 69 S
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77705-1244
Mailing Address - Country:US
Mailing Address - Phone:409-724-0370
Mailing Address - Fax:409-724-0375
Practice Address - Street 1:4909 HIGHWAY 69 S
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77705-1244
Practice Address - Country:US
Practice Address - Phone:409-724-0370
Practice Address - Fax:409-724-0375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30550103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty