Provider Demographics
NPI:1568070258
Name:DHARMADASA, VIROSH (DPM)
Entity Type:Individual
Prefix:
First Name:VIROSH
Middle Name:
Last Name:DHARMADASA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9740 BARKER CYPRESS ROAD
Mailing Address - Street 2:STE 108B
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-7886
Mailing Address - Country:US
Mailing Address - Phone:281-550-3338
Mailing Address - Fax:281-550-3436
Practice Address - Street 1:9740 BARKER CYPRESS ROAD
Practice Address - Street 2:STE 108B
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-7886
Practice Address - Country:US
Practice Address - Phone:281-550-3338
Practice Address - Fax:281-550-3436
Is Sole Proprietor?:No
Enumeration Date:2020-07-19
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX692036213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery