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NPI Code Detail

MEDICARE: ISHA OLI DPT

MEDICARE:   ISHA  OLI  DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1295204790
Entity Type Code : Individual
Provider Name (Legal Business Name) : ISHA OLI DPT
Provider Business Mailing Address
First Line : 5617 ADAIR DR
Second Line :
City : AUSTIN
State : TX
Zip : 78754-5610
Country : US
Telephone Number : 562-282-6313
Fax Number :
Provider Business Practice Location Address
First Line : 1607 RANCH ROAD 620 N STE 500
Second Line :
City : LAKEWAY
State : TX
Zip : 78734-2331
Country : US
Telephone Number : 737-243-1600
Fax Number : 737-243-1601
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2018
Last Update Date : 04/10/2025

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Directions to “ ISHA OLI DPT” Practice Location

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