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NPI Code Detail

MEDICARE: SHIRLEY CAESAR PTA

MEDICARE:   SHIRLEY  CAESAR  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
1225200000XPhysical Therapy Assistant2004065TX

General Provider Information

NPI Number : 1811918808
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHIRLEY CAESAR PTA
Provider Business Mailing Address
First Line : 2407 LILY LN
Second Line :
City : HIGHLANDS
State : TX
Zip : 77562-3188
Country : US
Telephone Number : 281-426-6921
Fax Number :
Provider Business Practice Location Address
First Line : 2407 LILY LN
Second Line :
City : HIGHLANDS
State : TX
Zip : 77562-3188
Country : US
Telephone Number : 281-426-6921
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2006
Last Update Date : 07/08/2007

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Directions to “ SHIRLEY CAESAR PTA” Practice Location

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