Healthcare Provider Details

I. General information

NPI: 1013879337
Provider Name (Legal Business Name): MAJA VAZIC PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2025
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

806 E AVENUE D STE B&C
COPPERAS COVE TX
76522-2284
US

IV. Provider business mailing address

5576 W ROCHELLE AVE APT 16C
LAS VEGAS NV
89103-3414
US

V. Phone/Fax

Practice location:
  • Phone: 254-577-4938
  • Fax:
Mailing address:
  • Phone: 702-523-8727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberA-1681
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPT-2025-0272
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: