Provider Demographics
NPI:1659159762
Name:AKSHATA SATISH, FNU
Entity Type:Individual
Prefix:
First Name:FNU
Middle Name:
Last Name:AKSHATA SATISH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AKSHATA
Other - Middle Name:
Other - Last Name:SATISH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:9400 N CENTRAL EXPY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-5027
Mailing Address - Country:US
Mailing Address - Phone:562-247-5989
Mailing Address - Fax:
Practice Address - Street 1:1151 S EDGEFIELD AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-7099
Practice Address - Country:US
Practice Address - Phone:562-247-5989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX120085901Medicaid