Sybert Anne Lazaga

Individual provider Active NPI Physical Therapist · Groesbeck, TX

NPI 1073004693 · NPPES record last updated May 21, 2018

Key facts

NPI
1073004693
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
1278587 (TX)
Practice address
607 Parkside Dr
Groesbeck, TX 76642-1124
Phone
(254) 729-3245
NPI assigned
May 21, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1278587TXMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1278587 TX Yes

Addresses

Primary practice location

607 Parkside Dr
Groesbeck, TX 76642-1124

Mailing address

12272 W Sample Rd
Coral Springs, FL 33065-4227
Phone (954) 913-0839

Other identifiers

IdentifierTypeStateIssuer
L220-780-89-861-0OtherFLDRIVER'S LICENSE

Other providers in Groesbeck, TX

All providers in Groesbeck, TX · Physical Therapist in Texas

Sources for this page

Verify at the official NPI Registry.