Provider Demographics
NPI:1013386515
Name:SAKAL, ALISA
Entity Type:Individual
Prefix:
First Name:ALISA
Middle Name:
Last Name:SAKAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5587 DAVIS BLVD
Mailing Address - Street 2:SUITE 300G
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-6494
Mailing Address - Country:US
Mailing Address - Phone:817-918-4075
Mailing Address - Fax:
Practice Address - Street 1:5587 DAVIS BLVD
Practice Address - Street 2:SUITE 300G
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-6494
Practice Address - Country:US
Practice Address - Phone:817-918-4075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT 101676225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist