Provider Demographics
NPI:1972662260
Name:GHIMIRE, AVINASH (MD)
Entity type:Individual
Prefix:DR
First Name:AVINASH
Middle Name:
Last Name:GHIMIRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 HIGHWAY 71 E STE 201
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:TX
Mailing Address - Zip Code:78602-5157
Mailing Address - Country:US
Mailing Address - Phone:512-901-4010
Mailing Address - Fax:512-901-3910
Practice Address - Street 1:3101 HIGHWAY 71 E STE 201
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602-5157
Practice Address - Country:US
Practice Address - Phone:512-901-4010
Practice Address - Fax:512-901-3910
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT8408207RN0300X
MEMD19410207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1972662260OtherMEDICARE-UNSPECIFIED