1811877921 NPI number — DALLAS NEUROPSYCHOLOGY ASSOCIATES

Table of content: KALYANI SHRIRAM MARATHE MD, MPH (NPI 1114153764)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811877921 NPI number — DALLAS NEUROPSYCHOLOGY ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DALLAS NEUROPSYCHOLOGY ASSOCIATES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811877921
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/08/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
936 GRACE LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
THE COLONY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75056-3930
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-681-6707
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1785 STATE HIGHWAY 26 STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRAPEVINE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76051-2217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-681-6707
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/08/2025

Additional Information

Authorized Official

Authorized Official Last Name:
VAZQUEZ
Authorized Official First Name:
BRITTANY
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/NEUROPSYCHOLOGIST
Authorized Official Telephone Number:
214-681-6707

Provider Taxonomy Codes

  • Taxonomy code: 103G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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