Provider Demographics
NPI:1225335839
Name:YAKKALA, KARISHMA PATEL (DC)
Entity Type:Individual
Prefix:
First Name:KARISHMA
Middle Name:PATEL
Last Name:YAKKALA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6943 BLUEGRASS RUN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-2755
Mailing Address - Country:US
Mailing Address - Phone:281-221-2661
Mailing Address - Fax:281-494-1017
Practice Address - Street 1:600 DIVISION AVE
Practice Address - Street 2:SUITE G
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78214-1350
Practice Address - Country:US
Practice Address - Phone:210-332-9005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-16
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11572111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor