Provider Demographics
NPI:1528541216
Name:OGOTI, DANISH B
Entity type:Individual
Prefix:
First Name:DANISH
Middle Name:B
Last Name:OGOTI
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 1:1211 FOXTAIL DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-2327
Mailing Address - Country:US
Mailing Address - Phone:469-443-2876
Mailing Address - Fax:
Practice Address - Street 1:1211 FOXTAIL DR
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-2327
Practice Address - Country:US
Practice Address - Phone:469-443-2876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX307331164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse