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General NPI Number Information
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NPI Number | 1124849120
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Entity Type | Individual
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Provider Name | ALISHA MICHELLE HORTON MS, LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 10/22/2024
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 658 ROUGH RIDER DR
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City | CENTER
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State | TX
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Zip | 75935-5141
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Country | US
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Telephone | 936-598-6173
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Fax |
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Provider Business Mailing Address
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Address Line | 550 ROUGH RIDER DR
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City | CENTER
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State | TX
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Zip | 75935-5140
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Country | US
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Telephone | 251-377-9205
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | AT4921
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License Number State | TX
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