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NPI Code Detail

MEDICARE: MS. KETAL SISODIA

MEDICARE: MS. KETAL SISODIA
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 Therapist1221262TX

General Provider Information

NPI Number : 1306280557
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KETAL SISODIA
Provider Business Mailing Address
First Line : 21943 RUSTIC CANYON LN
Second Line :
City : RICHMOND
State : TX
Zip : 77469-5443
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2370 S DAIRY ASHFORD RD
Second Line :
City : HOUSTON
State : TX
Zip : 77077-5718
Country : US
Telephone Number : 281-589-8877
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2013
Last Update Date : 03/24/2014

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Directions to “ MS. KETAL SISODIA ” Practice Location

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