Provider Demographics
NPI:1902171226
Name:NISHA SATISH MD PA
Entity Type:Organization
Organization Name:NISHA SATISH MD PA
Other - Org Name:PRIMED SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SATISH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-453-3385
Mailing Address - Street 1:PO BOX 261092
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75026-1092
Mailing Address - Country:US
Mailing Address - Phone:903-453-3385
Mailing Address - Fax:972-454-1149
Practice Address - Street 1:301 DIVISION ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401-4101
Practice Address - Country:US
Practice Address - Phone:903-453-3385
Practice Address - Fax:972-454-1149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-20
Last Update Date:2015-10-08
Deactivation Date:2015-04-06
Deactivation Code:
Reactivation Date:2015-10-08
Provider Licenses
StateLicense IDTaxonomies
TXN3290207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty