Sharon Samuel Koruthu
Nurse Practitioner - Pediatrics
1935 Medical District Dr
Dallas
, Texas 75235-7701
Sharon Samuel Koruthu
Nurse Practitioner - Pediatrics
1935 Medical District Dr
Dallas
, Texas 75235-7701
(214) 893-5261
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About
Features
Specialties
- Nurse Practitioner - Pediatrics
Languages spoken
- English
Location
First Address
- Sharon Samuel Koruthu
- 2352 Comanche Trl
- Grand Prairie, TX
- Zip : 75052-8595
- Phone : (214) 893-5261
Second Address
- Sharon Samuel Koruthu
- 1935 Medical District Dr
- Dallas, TX
- Zip : 75235-7701
- Phone : (214) 456-7000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LP0200X | Nurse Practitioner - Pediatrics | AP125521 | TX |
National Provider Identifier
| NPI | 1033524020 |
|---|---|
| Provider Name | Sharon Samuel Koruthu |
| First Address | Grand Prairie, TX 75052-8595 |
| Second Address | Dallas, TX 75235-7701 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/06/2014 |
| Last Update Date | 04/02/2016 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.