Basic Information
| Provider Information | |||||||||
| NPI: | 1811477656 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | DOKTER | ||||||||
| FirstName: | HANNAH | ||||||||
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| Credential: | PTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 JACKSON LN | ||||||||
| Address2: | |||||||||
| City: | CHINA SPRING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 766332948 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2547151650 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1700 WOODGATE DR | ||||||||
| Address2: | |||||||||
| City: | WOODWAY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 767128600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2546665454 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2018 | ||||||||
| LastUpdateDate: | 08/21/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | 2076271 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.