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General NPI Number Information
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NPI Number | 1407244544
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Entity Type | Individual
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Provider Name | DEEPIKA KALLURI MEKA
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Gender | Female
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Dates
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Enumeration Date | 12/23/2014
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Last Update Date | 08/19/2020
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Provider Practice Location Address
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Address Line | 1517 NEWTON RANCH RD
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City | KELLER
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State | TX
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Zip | 76248-1655
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Country | US
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Telephone | 626-319-6625
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Fax |
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Provider Business Mailing Address
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Address Line | 1517 NEWTON RANCH RD
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City | KELLER
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State | TX
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Zip | 76248-1655
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Country | US
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Telephone | 626-319-6625
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | 1230828
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License Number State | TX
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