Provider Demographics
NPI:1235191651
Name:BAKSHI, TRUPTI (PT)
Entity Type:Individual
Prefix:MRS
First Name:TRUPTI
Middle Name:
Last Name:BAKSHI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:TRUPTI
Other - Middle Name:
Other - Last Name:ANTANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6644 PHEASANT RUN RD
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-1621
Mailing Address - Country:US
Mailing Address - Phone:708-655-0122
Mailing Address - Fax:
Practice Address - Street 1:6644 PHEASANT RUN RD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-1621
Practice Address - Country:US
Practice Address - Phone:708-655-0122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1216130225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX320281YP8BMedicare PIN
TX320281YP8BMedicare PIN
ILK25643Medicare ID - Type Unspecified