Provider Demographics
NPI:1669209623
Name:COBOS, TIANNA ALEXANDRIA (PT, DPT)
Entity type:Individual
Prefix:
First Name:TIANNA
Middle Name:ALEXANDRIA
Last Name:COBOS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13864 SONTERRA RANCH RD
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76262-4592
Mailing Address - Country:US
Mailing Address - Phone:817-846-0969
Mailing Address - Fax:
Practice Address - Street 1:27281 PYEATT LN # B
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77385-6904
Practice Address - Country:US
Practice Address - Phone:817-846-0969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1391619225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist