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General NPI Number Information
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NPI Number | 1033453550
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Entity Type | Organization
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Legal Business Name | SHELDON SONNENBERG
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Dates
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Enumeration Date | 11/21/2012
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Last Update Date | 12/17/2012
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Provider Practice Location Address
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Address Line | 2000 WINDY TER BLDG 10
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City | CEDAR PARK
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State | TX
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Zip | 78613-4287
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Country | US
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Telephone | 310-880-5513
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Fax |
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Provider Business Mailing Address
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Address Line | 4700 N CAPITAL OF TEXAS HWY APT 712
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City | AUSTIN
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State | TX
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Zip | 78746-1130
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Country | US
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Telephone | 310-880-5513
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | SHELDON SONNENBERG
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Credential | P.T., A.T.C.
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Telephone | 310-880-5513
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1174403
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License Number State | TX
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