Provider Demographics
NPI:1013434893
Name:PARUCHURI, KRISHNA PRATYUSHA (PT)
Entity Type:Individual
Prefix:
First Name:KRISHNA
Middle Name:PRATYUSHA
Last Name:PARUCHURI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5252 LYNGATE CT STE 203
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-1673
Mailing Address - Country:US
Mailing Address - Phone:703-239-2300
Mailing Address - Fax:703-239-2301
Practice Address - Street 1:651 N HIGHWAY 183 STE 350
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-7016
Practice Address - Country:US
Practice Address - Phone:512-456-7065
Practice Address - Fax:512-456-7112
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-23
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305212396225100000X
MD26563225100000X
TX1377227225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist