Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 2073349 | TX |
NPI | 1013498179 |
---|---|
Provider Name | Mrs. Tera Hix |
First Address | Gatesville, TX 76528-1718 |
Second Address | Gatesville, TX 76528-2764 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2018 |
Last Update Date | 27/08/2018 |