Individual
VIDYA PERUVAJE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CST/CSFA
Contact information
Practice address
6640 LISBURN LN, FRISCO, TX 75035-0791
(512) 300-6893
Mailing address
6640 LISBURN LN, FRISCO, TX 75035-0791
(512) 300-6893
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
109346
TX
Other
Enumeration date
11/09/2024
Last updated
11/09/2024
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