MEDICARE: SNEHA GOUD ATHELLI PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1406984	TX

General Provider Information

NPI Number	:	1114805348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SNEHA GOUD ATHELLI PT

Provider Business Mailing Address
First Line	:	10507 SMARTY JONES ST
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75035-5966
Country	:	US
Telephone Number	:	631-259-1678
Fax Number	:

Provider Business Practice Location Address
First Line	:	1729 N CENTRAL EXPY STE A
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75075-6977
Country	:	US
Telephone Number	:	469-786-0005
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2025
Last Update Date	:	08/28/2025

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