Individual
LATASHA N TATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2333 MANOR DRIVE, BRYAN, TX 77802
(979) 821-7327
Mailing address
117 SILKWOOD DR, BRYAN, TX 77803-3541
(832) 334-1655
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2054700
TX
Other
Enumeration date
03/22/2013
Last updated
03/22/2013
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