Provider Demographics
NPI:1609098524
Name:THIPPAREDDY, GOPINATH (PT)
Entity Type:Individual
Prefix:
First Name:GOPINATH
Middle Name:
Last Name:THIPPAREDDY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5350 INDEPENDENCE PARKWAY
Mailing Address - Street 2:110B
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035
Mailing Address - Country:US
Mailing Address - Phone:972-587-9404
Mailing Address - Fax:972-587-9414
Practice Address - Street 1:5350 INDEPENDENCE PARKWAY
Practice Address - Street 2:110B
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035
Practice Address - Country:US
Practice Address - Phone:972-587-9404
Practice Address - Fax:972-587-9414
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1241026225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist