Provider Demographics
NPI:1144983024
Name:VELANKAR, MAITHILI AMEYA
Entity type:Individual
Prefix:
First Name:MAITHILI
Middle Name:AMEYA
Last Name:VELANKAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MAITHILI
Other - Middle Name:VIJAY
Other - Last Name:SANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1601 N COLLINS BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3520
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1601 N COLLINS BLVD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3520
Practice Address - Country:US
Practice Address - Phone:972-470-5855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113940225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist