Provider Demographics
NPI:1497465256
Name:BANDINI, SHARRON ANN (PTA)
Entity Type:Individual
Prefix:MRS
First Name:SHARRON
Middle Name:ANN
Last Name:BANDINI
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12309 SWAE LEE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77048-1256
Mailing Address - Country:US
Mailing Address - Phone:281-748-8702
Mailing Address - Fax:
Practice Address - Street 1:12309 SWAE LEE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77048-1256
Practice Address - Country:US
Practice Address - Phone:281-748-8702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2138083225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty