Provider Demographics
NPI:1760724413
Name:HANDA, ATUL (PT, MS)
Entity Type:Individual
Prefix:
First Name:ATUL
Middle Name:
Last Name:HANDA
Suffix:
Gender:M
Credentials:PT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5302 JANELLE DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-5666
Mailing Address - Country:US
Mailing Address - Phone:254-699-3933
Mailing Address - Fax:254-526-8604
Practice Address - Street 1:5302 JANELLE DR
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-5666
Practice Address - Country:US
Practice Address - Phone:254-699-3933
Practice Address - Fax:254-526-8604
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-20
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1225570225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist