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General NPI Number Information
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NPI Number | 1518513449
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Entity Type | Individual
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Provider Name | DANIELLE FARZANEGAN
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Gender | Female
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Dates
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Enumeration Date | 08/15/2019
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Last Update Date | 08/15/2019
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Provider Practice Location Address
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Address Line | 18200 KATY FWY
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City | HOUSTON
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State | TX
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Zip | 77094-1285
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Country | US
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Telephone | 919-302-6875
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Fax |
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Provider Business Mailing Address
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Address Line | 2033 S GESSNER RD APT 2227
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City | HOUSTON
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State | TX
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Zip | 77063-1164
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Country | US
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Telephone |
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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 | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 1318785
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License Number State | TX
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