Provider Demographics
NPI:1578289450
Name:SARZA, SERGIO TALABOC JR (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SERGIO
Middle Name:TALABOC
Last Name:SARZA
Suffix:JR
Gender:M
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 1:685 PROVIDENCE MAIN ST NW APT 322
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-2660
Mailing Address - Country:US
Mailing Address - Phone:256-996-6818
Mailing Address - Fax:
Practice Address - Street 1:685 PROVIDENCE MAIN ST NW APT 322
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-2660
Practice Address - Country:US
Practice Address - Phone:256-996-6818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1311256225100000X
WAPT60762627225100000X
ALPTH10748225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist