Provider Demographics
NPI:1164806923
Name:PULKUR, PRIYANKA (LPC)
Entity Type:Individual
Prefix:
First Name:PRIYANKA
Middle Name:
Last Name:PULKUR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2630 BISSONNET ST APT 3112
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-1486
Mailing Address - Country:US
Mailing Address - Phone:713-252-4821
Mailing Address - Fax:844-583-5633
Practice Address - Street 1:101 SOUTHWESTERN BLVD
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3668
Practice Address - Country:US
Practice Address - Phone:877-583-5633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-11
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71703101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health