Healthcare Provider Details

I. General information

NPI: 1861236861
Provider Name (Legal Business Name): ALAYNA ZUIDERWEG DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 DAVIS LN BLDG A
AUSTIN TX
78749-4071
US

IV. Provider business mailing address

4323 S CONGRESS AVE APT 2348
AUSTIN TX
78745-0072
US

V. Phone/Fax

Practice location:
  • Phone: 512-301-8747
  • Fax:
Mailing address:
  • Phone: 614-309-0164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1385921
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: