Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 1177953 | TX |
NPI | 1033792585 |
---|---|
Provider Name | Julie K Hackett |
First Address | Houston, TX 77030-2399 |
Second Address | Houston, TX 77030-2399 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2021 |
Last Update Date | 03/05/2021 |