Provider Demographics
NPI:1538557632
Name:DHULIPALLA, TULASI
Entity type:Individual
Prefix:
First Name:TULASI
Middle Name:
Last Name:DHULIPALLA
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 1:2727 BENS BRANCH DR APT 1407
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-3746
Mailing Address - Country:US
Mailing Address - Phone:773-369-4102
Mailing Address - Fax:
Practice Address - Street 1:2727 BENS BRANCH DR APT 1407
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-3746
Practice Address - Country:US
Practice Address - Phone:773-369-4102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-26
Last Update Date:2014-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1222348225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist