Provider Demographics
NPI:1346720570
Name:PINNAMARAJU, HEMA S (PT)
Entity Type:Individual
Prefix:
First Name:HEMA
Middle Name:S
Last Name:PINNAMARAJU
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26003 PARTY SLIPPERS DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78255-3436
Mailing Address - Country:US
Mailing Address - Phone:814-549-0660
Mailing Address - Fax:
Practice Address - Street 1:26003 PARTY SLIPPERS DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78255-3436
Practice Address - Country:US
Practice Address - Phone:814-549-0660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-16
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1347297225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1347297OtherPT
TX1347297Medicaid