Provider Demographics
NPI:1033708029
Name:MAHESHWARI, NUPUR (MPT)
Entity Type:Individual
Prefix:
First Name:NUPUR
Middle Name:
Last Name:MAHESHWARI
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 W FORK APT 3535
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-5073
Mailing Address - Country:US
Mailing Address - Phone:312-723-5555
Mailing Address - Fax:
Practice Address - Street 1:14665 MIDWAY RD STE 110
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-3185
Practice Address - Country:US
Practice Address - Phone:972-382-9732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1327650225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist