Provider Demographics
NPI:1366732968
Name:RATH, NACIKETA (DO)
Entity type:Individual
Prefix:DR
First Name:NACIKETA
Middle Name:
Last Name:RATH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3816 NASH LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-2031
Mailing Address - Country:US
Mailing Address - Phone:954-249-0554
Mailing Address - Fax:
Practice Address - Street 1:3816 NASH LN
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-2031
Practice Address - Country:US
Practice Address - Phone:954-249-0554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-15
Last Update Date:2014-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA-1831-14207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine