Individual
MS. AVANTIKA CADAMBI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
957 MONARCH WAY, KELLER, TX 76248-5266
(817) 562-4879
Mailing address
PO BOX 11219, FORT WORTH, TX 76110-0219
(817) 294-7444
(817) 294-7172
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
617986
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
051958
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0031031-09
—
TX
05
—
003103107
—
TX
01
—
8473UA
BCBS
—
Enumeration date
12/28/2005
Last updated
07/31/2012
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