Provider Demographics
NPI:1306852140
Name:SRINIVASAN, AARATHI (DPT)
Entity Type:Individual
Prefix:
First Name:AARATHI
Middle Name:
Last Name:SRINIVASAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:AARATHI
Other - Middle Name:
Other - Last Name:GANGADHARAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:702 NEWINGTON LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2799
Mailing Address - Country:US
Mailing Address - Phone:763-742-3375
Mailing Address - Fax:
Practice Address - Street 1:702 NEWINGTON LN
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2799
Practice Address - Country:US
Practice Address - Phone:763-742-3375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7861225100000X
TX1324528225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist