Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 1304809 | TX |
NPI | 1013542513 |
---|---|
Provider Name | Dr. Alexis Nicole Shoope |
First Address | Houston, TX 77027-5992 |
Second Address | Houston, TX 77027-5992 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2020 |
Last Update Date | 05/03/2020 |