Provider Demographics
NPI:1992905566
Name:SENAN, NISHA (MD)
Entity type:Individual
Prefix:
First Name:NISHA
Middle Name:
Last Name:SENAN
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 130385
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77393-0385
Mailing Address - Country:US
Mailing Address - Phone:812-825-3344
Mailing Address - Fax:281-825-3340
Practice Address - Street 1:129 VISION PARK BLVD STE 205
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77384-3024
Practice Address - Country:US
Practice Address - Phone:281-825-3344
Practice Address - Fax:281-825-3340
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN7406207R00000X
MI4301090854207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine