Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 13396 | TX |
N | 111NN1001X | Nutrition | 13396 | TX |
NPI | 1447747217 |
---|---|
Provider Name | Dr. Sasha Cora |
First Address | Universal City, TX 78148-1912 |
Second Address | Live Oak, TX 78233-2618 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2018 |
Last Update Date | 17/04/2018 |