=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972311900
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ABHISHEK HANDA PTA
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/23/2024
-----------------------------------------------------
Last Update Date | 02/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 201 E CENTRAL TEXAS EXPY STE 1170
-----------------------------------------------------
City | HARKER HEIGHTS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76548-2786
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-901-0039
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 201 E CENTRAL TEXAS EXPY STE 1170
-----------------------------------------------------
City | HARKER HEIGHTS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76548-2786
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 417-755-3222
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225200000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Assistant
-----------------------------------------------------
License Number | 2186744
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 1406141
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------