Provider Demographics
NPI:1922508647
Name:KAUR, PRITAM
Entity Type:Individual
Prefix:MRS
First Name:PRITAM
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 MELVIN DR
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-8127
Mailing Address - Country:US
Mailing Address - Phone:469-831-0005
Mailing Address - Fax:
Practice Address - Street 1:3401 MELVIN DR
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-8127
Practice Address - Country:US
Practice Address - Phone:469-831-0005
Practice Address - Fax:469-831-0005
Is Sole Proprietor?:No
Enumeration Date:2018-02-19
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant