Provider Demographics
NPI:1871681775
Name:BIRCHFIELD, ANGELA WAYNETTE (LAT)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:WAYNETTE
Last Name:BIRCHFIELD
Suffix:
Gender:F
Credentials:LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3506 WOODMERE LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-5225
Mailing Address - Country:US
Mailing Address - Phone:281-468-4890
Mailing Address - Fax:281-340-6489
Practice Address - Street 1:15400 SOUTHWEST FWY STE 100
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3876
Practice Address - Country:US
Practice Address - Phone:281-340-6451
Practice Address - Fax:281-340-6489
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT16322255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer