Provider Demographics
NPI:1558480269
Name:KHALSA, GURUBACHAN KAUR (CPM , LM)
Entity Type:Individual
Prefix:MRS
First Name:GURUBACHAN
Middle Name:KAUR
Last Name:KHALSA
Suffix:
Gender:F
Credentials:CPM , LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 PANORAMA DR
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-2515
Mailing Address - Country:US
Mailing Address - Phone:512-264-9727
Mailing Address - Fax:
Practice Address - Street 1:700 PANORAMA DR
Practice Address - Street 2:
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620-2515
Practice Address - Country:US
Practice Address - Phone:512-264-9727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX96010176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife