Provider Demographics
NPI:1104472273
Name:RUPESH, PRIYA (NP)
Entity type:Individual
Prefix:
First Name:PRIYA
Middle Name:
Last Name:RUPESH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:PRIYA
Other - Middle Name:THANKAPPAN
Other - Last Name:SULOCHANA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:11608 VISTA PARK CT
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7441
Mailing Address - Country:US
Mailing Address - Phone:832-888-8363
Mailing Address - Fax:
Practice Address - Street 1:11608 VISTA PARK CT
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7441
Practice Address - Country:US
Practice Address - Phone:832-888-8363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-14
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142621363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care