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NPI Code Detail

MEDICARE: SOWMYA KOKKU

MEDICARE: SOWMYA KOKKU
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
1225100000XPhysical Therapist1408076TX
2225100000XPhysical Therapist053487NY

General Provider Information

NPI Number : 1578423109
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOWMYA KOKKU
Provider Business Mailing Address
First Line : 5000 N STATE HIGHWAY 161 APT 2109
Second Line :
City : IRVING
State : TX
Zip : 75038-1490
Country : US
Telephone Number : 972-654-5966
Fax Number :
Provider Business Practice Location Address
First Line : 504 N CARRIER PKWY
Second Line : CLASSIC REHABILITATION, INC
City : GRAND PRAIRIE
State : TX
Zip : 75050-5428
Country : US
Telephone Number : 817-226-2622
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2025
Last Update Date : 04/12/2026

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Directions to “ SOWMYA KOKKU ” Practice Location

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