Organization
KSP HEALTH PLLC
Active
Other names
KSP HEALTH
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MANJULA MUTHUKUMAR (DIRECTOR)
(316) 516-2853
Entity
Organization
Contact information
Practice address
5900 BALCONES DR STE 100, AUSTIN, TX 78731-4298
(316) 516-2853
Mailing address
6505 E CENTRAL AVE STE 183, WICHITA, KS 67206-1924
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
11/29/2022
Last updated
11/29/2022
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