Individual
NISHA AMIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2300 HIGHWAY 365, #620, NEDERLAND, TX 77627-6256
(409) 724-7855
(409) 724-1495
Mailing address
4909 HIGHWAY 69 S, #620, BEAUMONT, TX 77705-1244
(409) 724-7855
(409) 724-1495
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
30550
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8J3096
MEDICARE PROVIDER ID #
TX
Enumeration date
10/17/2006
Last updated
12/12/2016
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