Provider Demographics
NPI:1407561186
Name:DHARIA, PRERNA (DPT)
Entity Type:Individual
Prefix:
First Name:PRERNA
Middle Name:
Last Name:DHARIA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 CLUB DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-5115
Mailing Address - Country:US
Mailing Address - Phone:718-864-6130
Mailing Address - Fax:
Practice Address - Street 1:604 CLUB DR
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-5115
Practice Address - Country:US
Practice Address - Phone:718-864-6130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant