Provider Demographics
NPI:1043088941
Name:OLIAPURATH, SEENA KURUVILA
Entity Type:Individual
Prefix:
First Name:SEENA
Middle Name:KURUVILA
Last Name:OLIAPURATH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1427 DEL MAR DR
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75060-4880
Mailing Address - Country:US
Mailing Address - Phone:817-395-2243
Mailing Address - Fax:
Practice Address - Street 1:1006 N CARRIER PKWY
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-3301
Practice Address - Country:US
Practice Address - Phone:972-263-7202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1141982207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology