Healthcare Provider Details

I. General information

NPI: 1437989225
Provider Name (Legal Business Name): NORMA ZELAYA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2024
Last Update Date: 08/06/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 DAVIS LN BLDG A
AUSTIN TX
78749-4071
US

IV. Provider business mailing address

10801 WAYNE RIDDELL LOOP APT 8111
AUSTIN TX
78748-4462
US

V. Phone/Fax

Practice location:
  • Phone: 512-301-8747
  • Fax:
Mailing address:
  • Phone: 361-220-4856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2162446
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: