MEDICARE: VISHNU PRIYA RAMAKRISHNAN MPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1283030	TX

General Provider Information

NPI Number	:	1043577505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VISHNU PRIYA RAMAKRISHNAN MPT

Provider Business Mailing Address
First Line	:	10320 COCHRON DR
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75072-2977
Country	:	US
Telephone Number	:	508-494-0996
Fax Number	:

Provider Business Practice Location Address
First Line	:	255 W LEBANON
Second Line	:	STE 116
City	:	FRISCO
State	:	TX
Zip	:	75036-3412
Country	:	US
Telephone Number	:	508-494-0996
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2012
Last Update Date	:	11/03/2022

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