Provider Demographics
NPI:1952598419
Name:PALANISAMY, NITHYA (MD)
Entity Type:Individual
Prefix:DR
First Name:NITHYA
Middle Name:
Last Name:PALANISAMY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-2987
Practice Address - Street 1:4510 MEDICAL CENTER DR STE 215
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1605
Practice Address - Country:US
Practice Address - Phone:972-542-8609
Practice Address - Fax:972-542-8613
Is Sole Proprietor?:No
Enumeration Date:2007-09-28
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN0338207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX196164103Medicaid
TX196164108Medicaid
TXP00998367OtherRAILROAD MEDICARE
TX196164102Medicaid
TX8L26010Medicare PIN
TXP00998367OtherRAILROAD MEDICARE
TX196164103Medicaid
TXTXB137574Medicare PIN