Healthcare Provider Details

I. General information

NPI: 1548741143
Provider Name (Legal Business Name): KALPANA SADHU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2018
Last Update Date: 08/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W STATE HIGHWAY 6
WACO TX
76712-4041
US

IV. Provider business mailing address

327 FANNIN BATTLEGROUND LN
GEORGETOWN TX
78628-6020
US

V. Phone/Fax

Practice location:
  • Phone: 254-761-8500
  • Fax:
Mailing address:
  • Phone: 281-903-4764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1259876
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: