Individual
QUEANH GIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
901 DISCOVERY BLVD, CEDAR PARK, TX 78613-2273
(512) 259-9993
Mailing address
13145 N HWY 183 APT 826, AUSTIN, TX 78750-3288
(512) 426-0798
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2097101
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2097101
PTA
TX
Enumeration date
08/20/2018
Last updated
08/20/2018
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