Individual
SHANDALENE GHANEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8868 RESEARCH BLVD STE 601, AUSTIN, TX 78758-8521
(512) 651-3000
Mailing address
8804 LA SIESTA BND, AUSTIN, TX 78749-3453
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2138518
TX
Other
Enumeration date
07/25/2018
Last updated
07/25/2018
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