Individual
SIVA PARUCHURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSA
Contact information
Practice address
1001 LAVON DR, GRAPEVINE, TX 76051-1123
(214) 227-2457
(214) 764-0880
Mailing address
1001 LAVON DR, GRAPEVINE, TX 76051-1123
(214) 227-2457
(214) 764-0880
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
SA00302
TX
246ZS0410X
Surgical Technologist
SA00302
TX
Other
Enumeration date
02/22/2012
Last updated
01/13/2022
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