Provider Demographics
NPI:1598878639
Name:ANDERSON, ANGELA C (PHYSICAL THERAPY)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:C
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PHYSICAL THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2315 RIVER LODGE LANE
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479
Mailing Address - Country:US
Mailing Address - Phone:281-342-2297
Mailing Address - Fax:281-344-8926
Practice Address - Street 1:2315 RIVER LODGE LN
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-8984
Practice Address - Country:US
Practice Address - Phone:281-342-2297
Practice Address - Fax:281-344-8926
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2010-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11209882251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics