Individual
TANAYA PATTNAIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8739 RIPPLING WATER DR, SUGAR LAND, TX 77479-6976
(530) 219-3614
Mailing address
8739 RIPPLING WATER DR, SUGAR LAND, TX 77479-6976
(530) 219-3614
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/30/2018
Last updated
03/25/2019
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