Provider Demographics
NPI:1265639843
Name:HYETT, SANDRA KAY (PT)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:KAY
Last Name:HYETT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 4TH ST
Mailing Address - Street 2:
Mailing Address - City:PALACIOS
Mailing Address - State:TX
Mailing Address - Zip Code:77465-3913
Mailing Address - Country:US
Mailing Address - Phone:361-972-2177
Mailing Address - Fax:
Practice Address - Street 1:1111 4TH ST
Practice Address - Street 2:
Practice Address - City:PALACIOS
Practice Address - State:TX
Practice Address - Zip Code:77465-3913
Practice Address - Country:US
Practice Address - Phone:361-972-2177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1001352225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist