Provider Demographics
NPI:1881399475
Name:FITZGERALD, ALYSSA (MAT, ATC)
Entity type:Individual
Prefix:MS
First Name:ALYSSA
Middle Name:
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:MAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11203 SAGEBERRY DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-4501
Mailing Address - Country:US
Mailing Address - Phone:832-477-0808
Mailing Address - Fax:
Practice Address - Street 1:11203 SAGEBERRY DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-4501
Practice Address - Country:US
Practice Address - Phone:832-477-0808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer