Provider Demographics
NPI:1073124301
Name:DE JOYA, ANNA LISA (PT, DSC, NCS)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:LISA
Last Name:DE JOYA
Suffix:
Gender:F
Credentials:PT, DSC, NCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3739 WAKEFOREST ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-5511
Mailing Address - Country:US
Mailing Address - Phone:713-854-1120
Mailing Address - Fax:
Practice Address - Street 1:3739 WAKEFOREST ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-5511
Practice Address - Country:US
Practice Address - Phone:713-854-1120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1106813261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy