Basic Information
Provider Information
NPI: 1548813439
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JASROTIA
FirstName: NANDINI
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: AUD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5220 W UNIVERSITY DR STE 150
Address2:  
City: MCKINNEY
State: TX
PostalCode: 750717418
CountryCode: US
TelephoneNumber: 9729841050
FaxNumber: 9729841376
Practice Location
Address1: 5220 W UNIVERSITY DR STE 150
Address2:  
City: MCKINNEY
State: TX
PostalCode: 750717418
CountryCode: US
TelephoneNumber: 9729841050
FaxNumber: 9729841376
Other Information
ProviderEnumerationDate: 07/19/2019
LastUpdateDate: 07/19/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
231H00000X81089TXY Speech, Language and Hearing Service ProvidersAudiologist 

No ID Information.


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