Provider Demographics
NPI:1407244544
Name:MEKA, DEEPIKA KALLURI
Entity Type:Individual
Prefix:
First Name:DEEPIKA
Middle Name:KALLURI
Last Name:MEKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1517 NEWTON RANCH RD
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-1655
Mailing Address - Country:US
Mailing Address - Phone:626-319-6625
Mailing Address - Fax:
Practice Address - Street 1:1517 NEWTON RANCH RD
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-1655
Practice Address - Country:US
Practice Address - Phone:626-319-6625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-23
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12308282251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics