Provider Demographics
NPI:1306239504
Name:KALRA, ARCHANA SUNDAR (PT)
Entity type:Individual
Prefix:
First Name:ARCHANA
Middle Name:SUNDAR
Last Name:KALRA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 TRANQUIL POND DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-8578
Mailing Address - Country:US
Mailing Address - Phone:248-961-0614
Mailing Address - Fax:
Practice Address - Street 1:825 W KEARNEY ST
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-3206
Practice Address - Country:US
Practice Address - Phone:972-288-7668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1206261225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist