Provider Demographics
NPI:1235566837
Name:KUKREJA, RUCHI S (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RUCHI
Middle Name:S
Last Name:KUKREJA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 NASA PARKWAY
Mailing Address - Street 2:STE 307
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058
Mailing Address - Country:US
Mailing Address - Phone:281-956-1032
Mailing Address - Fax:281-956-1040
Practice Address - Street 1:1110 NASA PARKWAY
Practice Address - Street 2:STE 307
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058
Practice Address - Country:US
Practice Address - Phone:281-956-1032
Practice Address - Fax:281-956-1040
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36648103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist