Provider Demographics
NPI:1053326413
Name:PRADIP KANANI MD AND HARINI KANANI MD PA
Entity type:Organization
Organization Name:PRADIP KANANI MD AND HARINI KANANI MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:PRADIP
Authorized Official - Middle Name:
Authorized Official - Last Name:KANANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-285-4141
Mailing Address - Street 1:2698 N GALLOWAY AVE
Mailing Address - Street 2:SUITE # 106
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-6383
Mailing Address - Country:US
Mailing Address - Phone:972-285-4141
Mailing Address - Fax:
Practice Address - Street 1:2698 N GALLOWAY AVE
Practice Address - Street 2:SUITE # 106
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-6383
Practice Address - Country:US
Practice Address - Phone:972-285-4141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX188775402Medicaid
TX188775401Medicaid
TX188775401Medicaid