MEDICARE: ALEZONDRIA MARIA SIKES R.KT

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	226300000X	Kinesiotherapist

General Provider Information

NPI Number	:	1477268902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEZONDRIA MARIA SIKES R.KT

Provider Business Mailing Address
First Line	:	7676 PHOENIX DR APT 1501
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-4724
Country	:	US
Telephone Number	:	601-674-1318
Fax Number	:

Provider Business Practice Location Address
First Line	:	5000 S 5TH AVE
Second Line	:
City	:	HINES
State	:	IL
Zip	:	60141-3030
Country	:	US
Telephone Number	:	708-202-3936
Fax Number	:

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

Provider Enumeration Date	:	01/19/2023
Last Update Date	:	01/19/2023

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