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General NPI Number Information
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NPI Number | 1255079596
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Entity Type | Individual
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Provider Name | MRS. MADHAVI DALI
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Gender | Female
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Dates
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Enumeration Date | 05/26/2022
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Last Update Date | 05/26/2022
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Provider Practice Location Address
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Address Line | 5310 DUVAL RD
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City | AUSTIN
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State | TX
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Zip | 78727-6658
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Country | US
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Telephone | 512-516-1240
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Fax |
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Provider Business Mailing Address
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Address Line | 3776 TOP ROCK LN
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City | ROUND ROCK
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State | TX
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Zip | 78681-1089
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Country | US
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Telephone | 512-516-1240
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1225037
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License Number State | TX
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