Provider Demographics
NPI:1841845997
Name:PAZARY, NICOLE (PT, DPT)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:PAZARY
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 1:13830 SAWYER RANCH RD STE 300
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-5514
Mailing Address - Country:US
Mailing Address - Phone:512-894-2194
Mailing Address - Fax:512-829-4682
Practice Address - Street 1:13830 SAWYER RANCH RD STE 300
Practice Address - Street 2:
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620-5514
Practice Address - Country:US
Practice Address - Phone:512-894-2194
Practice Address - Fax:512-829-4682
Is Sole Proprietor?:No
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1322571225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist