Provider Demographics
NPI:1992878557
Name:KARAKKATTIL, PRIYA (PTMS)
Entity type:Individual
Prefix:
First Name:PRIYA
Middle Name:
Last Name:KARAKKATTIL
Suffix:
Gender:F
Credentials:PTMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 SPRING VALLEY RD
Mailing Address - Street 2:SUITE 40
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-3956
Mailing Address - Country:US
Mailing Address - Phone:972-488-9686
Mailing Address - Fax:972-241-1936
Practice Address - Street 1:4801 SPRING VALLEY RD
Practice Address - Street 2:SUITE 40
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-3956
Practice Address - Country:US
Practice Address - Phone:972-488-9686
Practice Address - Fax:972-241-1936
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPT1126068225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist