Provider Demographics
NPI:1710154083
Name:MICHAEL, SHEELA (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:SHEELA
Middle Name:
Last Name:MICHAEL
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 GIOVANNI DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3878
Mailing Address - Country:US
Mailing Address - Phone:972-312-9374
Mailing Address - Fax:
Practice Address - Street 1:4400 GIOVANNI DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3878
Practice Address - Country:US
Practice Address - Phone:972-312-9374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1081586225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1081586OtherTEXAS PHYSICAL THERAPIST LICENCE