Provider Demographics
NPI:1740310275
Name:SCOVELL, ANNE ROSE (PT)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:ROSE
Last Name:SCOVELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:12708 RIATA VISTA CIR
Mailing Address - Street 2:STE#A126
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-7167
Mailing Address - Country:US
Mailing Address - Phone:512-637-2002
Mailing Address - Fax:
Practice Address - Street 1:9101 BURNET RD
Practice Address - Street 2:STE 103
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5254
Practice Address - Country:US
Practice Address - Phone:512-248-2422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-7052-22251P0200X
MEPT12462251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics