Provider Demographics
NPI:1194272195
Name:KHAMSINI, ANGELA
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:KHAMSINI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 FARRAH LN
Mailing Address - Street 2:APT 1125
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-4589
Mailing Address - Country:US
Mailing Address - Phone:346-900-5649
Mailing Address - Fax:
Practice Address - Street 1:1000 FARRAH LN
Practice Address - Street 2:APT 1125
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-4589
Practice Address - Country:US
Practice Address - Phone:346-900-5649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide