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Individual

MS. EINAT SHIMONI OGDEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4780 N JOSEY LN, CARROLLTON, TX 75010-4615
(972) 395-2293
(972) 395-2294
Mailing address
4780 N JOSEY LN, CARROLLTON, TX 75010-4615
(972) 395-2293
(972) 395-2294

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1143113
TX
225100000X
Physical Therapist
PT30406
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
854T72
BC/BS TX - EFFECT 02/01/2011
TX
01
8L12833
MEDICARE PART B - PRIOR TO 2/1/11
TX
01
P00954360
RAILROAD MEDICARE
TX
01
TXB121220
MEDICARE PART B - EFFECT 3/3/11
TX
01
ZZZ02708Z
BLUE SHIELD
CA
Enumeration date
10/17/2006
Last updated
09/23/2011
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