Provider Demographics
NPI:1437370392
Name:GIRISHA, PREETI (PT)
Entity Type:Individual
Prefix:MRS
First Name:PREETI
Middle Name:
Last Name:GIRISHA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:PREETI
Other - Middle Name:BASAVARAJ
Other - Last Name:PATIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1913 HATHAWAY LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-7841
Mailing Address - Country:US
Mailing Address - Phone:972-987-6543
Mailing Address - Fax:972-987-6543
Practice Address - Street 1:8615 FREEPORT PKWY,
Practice Address - Street 2:SUITE NO 225
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063
Practice Address - Country:US
Practice Address - Phone:972-812-3200
Practice Address - Fax:972-812-3215
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1170693225100000X
MI5501012501225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist