Healthcare Provider Details

I. General information

NPI: 1184238404
Provider Name (Legal Business Name): ANNALICIA TORRES PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2020
Last Update Date: 07/27/2023
Certification Date: 07/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 MEDICAL PKWY STE 109B
CEDAR PARK TX
78613-5012
US

IV. Provider business mailing address

4700 SETON CENTER PKWY STE 175
AUSTIN TX
78759-4107
US

V. Phone/Fax

Practice location:
  • Phone: 512-439-1000
  • Fax:
Mailing address:
  • Phone: 512-439-1000
  • Fax: 210-590-4585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: