Provider Demographics
NPI:1992385702
Name:KHADKA, TEJASWI (TPT, DPT, NCS)
Entity Type:Individual
Prefix:DR
First Name:TEJASWI
Middle Name:
Last Name:KHADKA
Suffix:
Gender:F
Credentials:TPT, DPT, NCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20424 HAYSTACK CV
Mailing Address - Street 2:
Mailing Address - City:SPICEWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:78669-6441
Mailing Address - Country:US
Mailing Address - Phone:512-261-3584
Mailing Address - Fax:512-524-3649
Practice Address - Street 1:20424 HAYSTACK CV
Practice Address - Street 2:
Practice Address - City:SPICEWOOD
Practice Address - State:TX
Practice Address - Zip Code:78669-6441
Practice Address - Country:US
Practice Address - Phone:512-261-3584
Practice Address - Fax:512-524-3649
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-14
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1339535225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty