Provider Demographics
NPI:1467830265
Name:AFRONDOZO, SARAH REGINA (LAT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:REGINA
Last Name:AFRONDOZO
Suffix:
Gender:F
Credentials:LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17003 MIDNIGHT SKY CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-4746
Mailing Address - Country:US
Mailing Address - Phone:832-640-5625
Mailing Address - Fax:
Practice Address - Street 1:17003 MIDNIGHT SKY CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-4746
Practice Address - Country:US
Practice Address - Phone:832-640-5625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-12
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT59082255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer