Provider Demographics
NPI:1407232481
Name:THARAKAN, ASHA TIJU (NP)
Entity type:Individual
Prefix:
First Name:ASHA
Middle Name:TIJU
Last Name:THARAKAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4716 ALLIANCE BLVD
Mailing Address - Street 2:SUITE 700
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093
Mailing Address - Country:US
Mailing Address - Phone:469-800-6000
Mailing Address - Fax:469-800-6030
Practice Address - Street 1:4716 ALLIANCE BLVD
Practice Address - Street 2:SUITE 700
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093
Practice Address - Country:US
Practice Address - Phone:469-800-6000
Practice Address - Fax:469-800-6030
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-03
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF339482-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily