Provider Demographics
NPI:1023584901
Name:AYARE, TANVI SANJAY (PT)
Entity type:Individual
Prefix:MISS
First Name:TANVI
Middle Name:SANJAY
Last Name:AYARE
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 1:4205 VISTA RD APT 302
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-2102
Mailing Address - Country:US
Mailing Address - Phone:508-736-9446
Mailing Address - Fax:
Practice Address - Street 1:4006 VISTA RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-2112
Practice Address - Country:US
Practice Address - Phone:713-943-1592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1289942225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist