Provider Demographics
NPI:1972215051
Name:NEBEL, GRACIA SALINAS (PT)
Entity Type:Individual
Prefix:
First Name:GRACIA
Middle Name:SALINAS
Last Name:NEBEL
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 1:19711 LAJUANA LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-6119
Mailing Address - Country:US
Mailing Address - Phone:281-731-9725
Mailing Address - Fax:
Practice Address - Street 1:5055 W. PANTHER CREEK
Practice Address - Street 2:
Practice Address - City:WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77388
Practice Address - Country:US
Practice Address - Phone:281-419-1699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1018802225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX07628545OtherDRIVERS LICENSE