Provider Demographics
NPI:1386474328
Name:KRISHNAPPA, DEEPAK MURALI (DPT)
Entity type:Individual
Prefix:
First Name:DEEPAK
Middle Name:MURALI
Last Name:KRISHNAPPA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19607 DOGWOOD WALK CT
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-5305
Mailing Address - Country:US
Mailing Address - Phone:713-458-0115
Mailing Address - Fax:
Practice Address - Street 1:6800 MARKET ST STE 2B
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-2448
Practice Address - Country:US
Practice Address - Phone:484-521-3440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT032478225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist