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General NPI Number Information
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NPI Number | 1114344082
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Entity Type | Individual
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Provider Name | MISS PEGGY SYMMANK
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Gender | Female
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Dates
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Enumeration Date | 03/27/2014
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Last Update Date | 03/27/2014
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Provider Practice Location Address
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Address Line | 19285 DAVID MEMORIAL DR
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City | SHENANDOAH
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State | TX
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Zip | 77385-8778
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Country | US
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Telephone | 281-419-1330
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Fax |
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Provider Business Mailing Address
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Address Line | 27401 TIMBER CIR
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City | MAGNOLIA
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State | TX
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Zip | 77354-3012
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Country | US
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Telephone | 713-806-7929
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2012183
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License Number State | TX
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