Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1309317 | TX |
N | 2251P0200X | Physical Therapist - Pediatrics | 1309317 | TX |
N | 2251X0800X | Physical Therapist - Orthopedic | 1309317 | TX |
NPI | 1134600778 |
---|---|
Provider Name | Natalie Stanislav |
First Address | Cypress, TX 77433-5322 |
Second Address | Cypress, TX 77433-5348 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2018 |
Last Update Date | 04/05/2021 |