Provider Demographics
NPI:1295204790
Name:OLI, ISHA (DPT)
Entity type:Individual
Prefix:
First Name:ISHA
Middle Name:
Last Name:OLI
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5617 ADAIR DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754-5610
Mailing Address - Country:US
Mailing Address - Phone:562-282-6313
Mailing Address - Fax:
Practice Address - Street 1:1607 RANCH ROAD 620 N STE 500
Practice Address - Street 2:
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78734-2331
Practice Address - Country:US
Practice Address - Phone:737-243-1600
Practice Address - Fax:737-243-1601
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-14
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty