Basic Information
| Provider Information | |||||||||
| NPI: | 1386236636 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | VYAS | ||||||||
| FirstName: | ANISHA | ||||||||
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| Credential: | RRT, RCP, PTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8787 SIENNA SPRINGS BLVD APT 913 | ||||||||
| Address2: | |||||||||
| City: | MISSOURI CITY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774596076 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5865330755 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2424 WILCREST DR STE 110 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770422772 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7136668287 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/08/2021 | ||||||||
| LastUpdateDate: | 03/02/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | 2160196 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.