Healthcare Provider Details

I. General information

NPI: 1598507659
Provider Name (Legal Business Name): ALEXANDRIA SLATER HUFF PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2024
Last Update Date: 06/10/2024
Certification Date: 06/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7801 N LAMAR BLVD STE A114
AUSTIN TX
78752-1049
US

IV. Provider business mailing address

7801 N LAMAR BLVD STE A114
AUSTIN TX
78752-1049
US

V. Phone/Fax

Practice location:
  • Phone: 512-646-4673
  • Fax: 512-729-0320
Mailing address:
  • Phone: 512-646-4673
  • Fax: 512-729-0320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number1390722
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: