Provider Demographics
NPI:1962832881
Name:SETTE-CORDOVA, MEGAN E (DPT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:E
Last Name:SETTE-CORDOVA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15614 HUEBNER RD STE 115
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-0993
Mailing Address - Country:US
Mailing Address - Phone:210-479-3334
Mailing Address - Fax:210-479-3338
Practice Address - Street 1:15614 HUEBNER RD STE 115
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78248-0993
Practice Address - Country:US
Practice Address - Phone:210-479-3334
Practice Address - Fax:210-479-3338
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-13
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1234390225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1234390OtherTEXAS BOARD OF PHYSICAL THERAPY EXAMINERS