Individual
MRS. SARA REBECCA WAGGANER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
103 DAVIS RD STE M, LEAGUE CITY, TX 77573-2769
(281) 338-6777
(281) 338-6778
Mailing address
103 DAVIS RD STE M, LEAGUE CITY, TX 77573-2769
(281) 338-6777
(281) 338-6778
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2045987
TX
261QP2000X
Physical Therapy Clinic/Center
2045987
TX
Other
Enumeration date
12/18/2014
Last updated
04/17/2023
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