Provider Demographics
NPI:1780473736
Name:VAS, ASHA KUPPACHI (PHD)
Entity type:Individual
Prefix:DR
First Name:ASHA
Middle Name:KUPPACHI
Last Name:VAS
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3213 WELLS DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-3120
Mailing Address - Country:US
Mailing Address - Phone:214-718-3612
Mailing Address - Fax:
Practice Address - Street 1:5500 SOUTHWESTERN MEDICAL AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7299
Practice Address - Country:US
Practice Address - Phone:214-718-3612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111617225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation