Provider Demographics
NPI:1861899072
Name:CHERIAN, DAISY (PA-C)
Entity type:Individual
Prefix:
First Name:DAISY
Middle Name:
Last Name:CHERIAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 SOUTHMORE AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77502-1134
Mailing Address - Country:US
Mailing Address - Phone:713-473-6400
Mailing Address - Fax:
Practice Address - Street 1:908 SOUTHMORE AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77502-1134
Practice Address - Country:US
Practice Address - Phone:713-473-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-03
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA06618363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant