MEDICARE: ALEXANDRIA MARIE SWANN PTA

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
1	225200000X	Physical Therapy Assistant

General Provider Information

NPI Number	:	1316698913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRIA MARIE SWANN PTA

Provider Business Mailing Address
First Line	:	3000 WOODLAND PARK DR APT 1720
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77082-2691
Country	:	US
Telephone Number	:	214-927-7077
Fax Number	:

Provider Business Practice Location Address
First Line	:	3000 WOODLAND PARK DR APT 1720
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77082-2691
Country	:	US
Telephone Number	:	214-927-7077
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2022
Last Update Date	:	01/14/2022

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Directions to “ ALEXANDRIA MARIE SWANN PTA” Practice Location

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