Healthcare Provider Details

I. General information

NPI: 1235974874
Provider Name (Legal Business Name): SIGAL OHAYON PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2024
Last Update Date: 06/26/2024
Certification Date: 06/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 MUSEUM WAY
FORT WORTH TX
76107-3058
US

IV. Provider business mailing address

3121 SHORELINE DR
BURLESON TX
76028-8312
US

V. Phone/Fax

Practice location:
  • Phone: 817-718-4563
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2066897
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: