Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 1148988 | TX |
NPI | 1063942233 |
---|---|
Provider Name | Sarah Meyer |
First Address | Coppell, TX 75019-3918 |
Second Address | Bedford, TX 76022-6408 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2017 |
Last Update Date | 19/06/2017 |