Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 2132466 | TX |
NPI | 1982187795 |
---|---|
Provider Name | Sarah Oliver |
First Address | League City, TX 77573-5780 |
Second Address | Pasadena, TX 77505-1400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2018 |
Last Update Date | 09/09/2018 |