Provider Demographics
NPI:1093330722
Name:KOCHUPARAMBIL, STEPHANIE (PA)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:KOCHUPARAMBIL
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:2630 BISSONNET ST APT 5213
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-1571
Mailing Address - Country:US
Mailing Address - Phone:214-608-2096
Mailing Address - Fax:
Practice Address - Street 1:5300 W PLANO PKWY STE 100
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4851
Practice Address - Country:US
Practice Address - Phone:972-733-7242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-09
Last Update Date:2023-10-25
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant