Healthcare Provider Details

I. General information

NPI: 1962016089
Provider Name (Legal Business Name): VERONIKA KHARAMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2020
Last Update Date: 01/10/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6301 GASTON AVE
DALLAS TX
75214-3922
US

IV. Provider business mailing address

3824 CEDAR SPRINGS RD # 209
DALLAS TX
75219-4136
US

V. Phone/Fax

Practice location:
  • Phone: 214-295-5374
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number121046
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: