Provider Demographics
NPI:1386429520
Name:BOPARAI, GURLEEN KAUR
Entity type:Individual
Prefix:
First Name:GURLEEN
Middle Name:KAUR
Last Name:BOPARAI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 CYPRUS GROVE DR
Mailing Address - Street 2:
Mailing Address - City:LAVON
Mailing Address - State:TX
Mailing Address - Zip Code:75166-4713
Mailing Address - Country:US
Mailing Address - Phone:929-499-4858
Mailing Address - Fax:
Practice Address - Street 1:235 CYPRUS GROVE DR
Practice Address - Street 2:
Practice Address - City:LAVON
Practice Address - State:TX
Practice Address - Zip Code:75166-4713
Practice Address - Country:US
Practice Address - Phone:929-499-4858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-23-269694106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician