MRS. THRESIAMMA IDICHANDY NURSE PRACTITIONER NPI 1063422319

NPI Information

  • NPI: 1063422319
  • Provider Name: MRS. THRESIAMMA IDICHANDY, NURSE PRACTITIONER
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 234 W CAMPBELL RD
    RICHARDSON, TX
    ZIP 75080
  • Phone: (972) 474-3221

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NPI Details

MRS. Thresiamma Idichandy, NURSE PRACTITIONER is a family nurse practitioner in Richardson, TX with 26 years of experience. MRS. Thresiamma Idichandy, NURSE PRACTITIONER NPI is 1063422319. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

234 W CAMPBELL RD
RICHARDSON, TX
ZIP 75080-512
Phone: (972) 474-3221
Fax: (512) 782-9316

The NPI 1063422319 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 8/9/2006 and was last updated on 10/7/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily1207120TEXASYes
2363LF0000XNurse PractitionerFamily4704171067MICHIGANNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14704171067OTHERMICHIGANREGISTERED NNURSE
21207120OTHERTEXASTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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