Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 1162472 | TX |
NPI | 1013396357 |
---|---|
Provider Name | Hypatia Copple |
First Address | Sachse, TX 75048-5530 |
Second Address | Sachse, TX 75048-5530 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2015 |
Last Update Date | 19/05/2015 |