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General NPI Number Information
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NPI Number | 1922820554
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Entity Type | Individual
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Provider Name | GRETTA SOPHIA HOTZ
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Gender | Female
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Dates
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Enumeration Date | 10/25/2024
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 1921 PRESTON RD STE 2074
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City | PLANO
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State | TX
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Zip | 75093
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Country | US
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Telephone | 972-905-6622
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Fax | 972-942-4073
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Provider Business Mailing Address
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Address Line | 1200 CORPORATE DR STE 400
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City | HOOVER
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State | AL
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Zip | 35242
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1401736
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License Number State | TX
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