Healthcare Provider Details

I. General information

NPI: 1902700586
Provider Name (Legal Business Name): SANDRA BILLINGSLEY PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

523 E 6TH ST
EL DORADO AR
71730-4007
US

IV. Provider business mailing address

647 PRATT RD
BERNICE LA
71222-4711
US

V. Phone/Fax

Practice location:
  • Phone: 318-224-8994
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberCP043804A
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: