Provider Demographics
NPI:1033966486
Name:KARISHMA, FNU
Entity type:Individual
Prefix:
First Name:FNU
Middle Name:
Last Name:KARISHMA
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 1:1828 ROADRUNNER DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-8678
Mailing Address - Country:US
Mailing Address - Phone:469-353-1826
Mailing Address - Fax:
Practice Address - Street 1:9560 LEGACY DR STE 210
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-6761
Practice Address - Country:US
Practice Address - Phone:214-705-3132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1391153225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist