Individual
MRS. CHERYL E. WANEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
4607 MENCHACA RD, AUSTIN, TX 78745-1607
(512) 916-1511
(512) 916-1532
Mailing address
9101 BURNET RD, SUITE 103, AUSTIN, TX 78758-5254
(512) 248-2422
(512) 248-2354
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1051456
TX
225100000X
Physical Therapist
1429-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0626582-01
—
TX
01
—
122582
SUPERIOR HEALTHPLAN
—
01
—
84340T
BLUE CROSS BLUE SHIELD
—
Enumeration date
05/10/2006
Last updated
10/08/2024
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