Healthcare Provider Details

I. General information

NPI: 1124495981
Provider Name (Legal Business Name): ALANNA DIBIASI DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2015
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11675 JOLLYVILLE RD STE 151
AUSTIN TX
78759-4149
US

IV. Provider business mailing address

11675 JOLLYVILLE RD STE 207
AUSTIN TX
78759-4105
US

V. Phone/Fax

Practice location:
  • Phone: 512-856-1000
  • Fax: 512-856-4040
Mailing address:
  • Phone: 512-856-1000
  • Fax: 512-856-4040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number1277363
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT024639
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT024639
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: