Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | ||
Y | 2251S0007X | Physical Therapist - Sports | 1176458 | TX |
NPI | 1063980472 |
---|---|
Provider Name | Mrs. Purvi Shaan Vora |
First Address | Seattle, WA 98122-6534 |
Second Address | Houston, TX 77094-1285 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2018 |
Last Update Date | 26/08/2021 |