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Individual
DEEPA POULOSE
Active
Individual
DEEPA POULOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP125997
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
359331103
—
TX
05
—
359331104
—
TX
Enumeration date
08/04/2014
Last updated
10/16/2017
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