Basic Information
| Provider Information | |||||||||
| NPI: | 1558094623 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | KURIEN | ||||||||
| FirstName: | BISMI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 287 WOODED GLEN DR | ||||||||
| Address2: | |||||||||
| City: | SUNNYVALE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 751822653 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 210 W CAMPBELL RD | ||||||||
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| City: | RICHARDSON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750803512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9729796577 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2022 | ||||||||
| LastUpdateDate: | 07/06/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.