Provider Demographics
NPI:1629297916
Name:MODY, SONAL KIRIT (MPT)
Entity Type:Individual
Prefix:
First Name:SONAL
Middle Name:KIRIT
Last Name:MODY
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4015 LAGUNA POINT LN
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-5038
Mailing Address - Country:US
Mailing Address - Phone:443-739-8381
Mailing Address - Fax:
Practice Address - Street 1:4015 LAGUNA POINT LN
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-5038
Practice Address - Country:US
Practice Address - Phone:443-739-8381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 29213225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist