Provider Demographics
NPI:1194139865
Name:RAJASEKARAN, NISHA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NISHA
Middle Name:
Last Name:RAJASEKARAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:NISHA
Other - Middle Name:
Other - Last Name:HULL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:10301 STELLA LINK RD STE C
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-5447
Mailing Address - Country:US
Mailing Address - Phone:937-286-3198
Mailing Address - Fax:
Practice Address - Street 1:10301 STELLA LINK RD STE C
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-5447
Practice Address - Country:US
Practice Address - Phone:937-286-3198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-20
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX48617183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist