Individual
DR. SREEKUMARAN NAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
915 S MAIN ST STE A, FORT WORTH, TX 76104-3408
(817) 336-2026
(817) 336-5996
Mailing address
915 S MAIN ST STE A, FORT WORTH, TX 76104-3408
(817) 336-2026
(817) 336-5996
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
J8071
TX
2084N0400X
Neurology Physician
Primary
J8071
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00656D
BLUE CROSS BLUE SHIELD
TX
01
—
10028895
AMERIGROUP
TX
05
—
1136426-02
—
TX
01
—
75043
AMERICAID
TX
Enumeration date
05/26/2006
Last updated
02/12/2024
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