Provider Demographics
NPI:1831441898
Name:MERCHANT, NUPUR
Entity type:Individual
Prefix:MRS
First Name:NUPUR
Middle Name:
Last Name:MERCHANT
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 1:604 FORT WORTH AVENUE
Mailing Address - Street 2:APT 3011
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-7299
Mailing Address - Country:US
Mailing Address - Phone:972-814-7654
Mailing Address - Fax:
Practice Address - Street 1:7100 MATLOCK RD.
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76002
Practice Address - Country:US
Practice Address - Phone:817-466-2511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-15
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017207225X00000X
TX113849225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist