Provider Demographics
NPI:1124849120
Name:HORTON, ALISHA MICHELLE (MS, LAT, ATC)
Entity type:Individual
Prefix:MRS
First Name:ALISHA
Middle Name:MICHELLE
Last Name:HORTON
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 ROUGH RIDER DR
Mailing Address - Street 2:
Mailing Address - City:CENTER
Mailing Address - State:TX
Mailing Address - Zip Code:75935-5140
Mailing Address - Country:US
Mailing Address - Phone:251-377-9205
Mailing Address - Fax:
Practice Address - Street 1:658 ROUGH RIDER DR
Practice Address - Street 2:
Practice Address - City:CENTER
Practice Address - State:TX
Practice Address - Zip Code:75935-5141
Practice Address - Country:US
Practice Address - Phone:936-598-6173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
TXAT49212081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine