Provider Demographics
NPI:1659088201
Name:ANZALOTTI, GLADYS (PT)
Entity Type:Individual
Prefix:
First Name:GLADYS
Middle Name:
Last Name:ANZALOTTI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24442 N TIDE BAY CIR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-1584
Mailing Address - Country:US
Mailing Address - Phone:832-373-2448
Mailing Address - Fax:
Practice Address - Street 1:24442 N TIDE BAY CIR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-1584
Practice Address - Country:US
Practice Address - Phone:832-373-2448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1283588225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist