Provider Demographics
NPI:1578806816
Name:URLAM, LAKSHMI DEEPTI (PT)
Entity Type:Individual
Prefix:
First Name:LAKSHMI DEEPTI
Middle Name:
Last Name:URLAM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LAKSHMI DEEPTI
Other - Middle Name:
Other - Last Name:PAKKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4323 CANADIAN RIVER DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-5401
Mailing Address - Country:US
Mailing Address - Phone:404-358-5938
Mailing Address - Fax:
Practice Address - Street 1:1449 HIGHWAY 6
Practice Address - Street 2:SUITE 260
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5145
Practice Address - Country:US
Practice Address - Phone:281-240-3140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-05
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2094661225200000X
TX1229435225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant