Healthcare Provider Details

I. General information

NPI: 1184081887
Provider Name (Legal Business Name): SHRADDHA WASHINDKAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2016
Last Update Date: 01/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1432 WINTERWOOD DR
ALLEN TX
75002-4959
US

IV. Provider business mailing address

1432 WINTERWOOD DR
ALLEN TX
75002-4959
US

V. Phone/Fax

Practice location:
  • Phone: 214-575-9820
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1243892
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: