Provider Demographics
NPI:1700455235
Name:PARTHASARATHY, SOWMYA SARAGUR
Entity Type:Individual
Prefix:
First Name:SOWMYA
Middle Name:SARAGUR
Last Name:PARTHASARATHY
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 1:1405 W 34TH ST APT A107
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-6261
Mailing Address - Country:US
Mailing Address - Phone:346-561-2810
Mailing Address - Fax:
Practice Address - Street 1:7505 BELLERIVE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3003
Practice Address - Country:US
Practice Address - Phone:713-774-9611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-19
Last Update Date:2021-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1329813225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist