Provider Demographics
NPI:1770914582
Name:KOENIG, ANJANETTE
Entity type:Individual
Prefix:
First Name:ANJANETTE
Middle Name:
Last Name:KOENIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANJANETTE
Other - Middle Name:
Other - Last Name:BUTTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20700 KINGSLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-2705
Mailing Address - Country:US
Mailing Address - Phone:281-237-9269
Mailing Address - Fax:281-644-1763
Practice Address - Street 1:20700 KINGSLAND BLVD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2705
Practice Address - Country:US
Practice Address - Phone:281-237-9269
Practice Address - Fax:281-644-1763
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-04
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT18442255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer