Provider Demographics
NPI:1275982167
Name:SAWALL, TIFFANIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:TIFFANIE
Middle Name:
Last Name:SAWALL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 COOPER DR
Mailing Address - Street 2:STE 130
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-3910
Mailing Address - Country:US
Mailing Address - Phone:214-575-2663
Mailing Address - Fax:214-575-2664
Practice Address - Street 1:600 COOPER DR
Practice Address - Street 2:STE 130
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-3910
Practice Address - Country:US
Practice Address - Phone:214-575-2663
Practice Address - Fax:214-575-2664
Is Sole Proprietor?:No
Enumeration Date:2016-06-10
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1274219225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist