Provider Demographics
NPI:1851666705
Name:STROADE, DANIEL LEE (PTA)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:LEE
Last Name:STROADE
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7406 GENEVA DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723
Mailing Address - Country:US
Mailing Address - Phone:903-388-2211
Mailing Address - Fax:
Practice Address - Street 1:1110 NASA PKWY
Practice Address - Street 2:STE 201
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3310
Practice Address - Country:US
Practice Address - Phone:713-532-6600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-11
Last Update Date:2012-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2078740225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant