Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 2074283 | TX |
NPI | 1013499680 |
---|---|
Provider Name | Angela Mccaughey |
First Address | San Antonio, TX 78213-1372 |
Second Address | Austin, TX 78754 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2018 |
Last Update Date | 30/08/2018 |