Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 1262291 | TX |
NPI | 1033734165 |
---|---|
Provider Name | Elizabeth Chalambaga |
First Address | Midland, TX 79703-5112 |
Second Address | Pearland, TX 77581-5945 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2020 |
Last Update Date | 15/06/2020 |