Provider Demographics
NPI:1710172028
Name:CRISP, SYLVIA JEAN (PT)
Entity Type:Individual
Prefix:MS
First Name:SYLVIA
Middle Name:JEAN
Last Name:CRISP
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:PO BOX 8370
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78599-8370
Mailing Address - Country:US
Mailing Address - Phone:956-968-7420
Mailing Address - Fax:
Practice Address - Street 1:4301 S EXPRESSWAY 83
Practice Address - Street 2:GOOD SAMARITAN CENTER
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550
Practice Address - Country:US
Practice Address - Phone:956-412-5826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000479225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist