| Doctor Name: | NISHA DESAI |
| NPI Number: | 1639493497 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | O.T. |
| License Number: | 111440 |
| Business Practice Address: | 501 S Austin Ave Suite 1310 Georgetown, TX - 786265637 |
| Business Phone Number: | 5128646054 |
| Business Fax Number: | 5128698157 |
| Mailing Address: | 501 S Austin Ave, Suite 1310 GEORGETOWN |
| State: | TX |
| Postal Code: | 786265637 |
| Phone Number: | 5128646054 |
| Fax Number: | 5128698157 |
| NPI Enumeration Date: | 03/23/2010 |
| NPI Last Update Date: | 03/23/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 111440 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |