Provider Demographics
NPI:1013380963
Name:THANKANCHAN, DEEPIKA (APRN)
Entity Type:Individual
Prefix:
First Name:DEEPIKA
Middle Name:
Last Name:THANKANCHAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 CROSS TIMBERS RD STE 1250
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-8824
Mailing Address - Country:US
Mailing Address - Phone:214-488-0121
Mailing Address - Fax:972-459-2656
Practice Address - Street 1:1001 CROSS TIMBERS RD STE 1250
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-8824
Practice Address - Country:US
Practice Address - Phone:214-488-0121
Practice Address - Fax:972-459-2656
Is Sole Proprietor?:No
Enumeration Date:2015-10-31
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129502363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health