Misty Rene Smith, PTA

Individual provider Active NPI Physical Therapy Assistant · Sweeny, TX

NPI 1659920650 · NPPES record last updated Sep 11, 2019

Key facts

NPI
1659920650
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
2071171 (TX)
Practice address
5934 County Road 289
Sweeny, TX 77480-4024
Phone
(979) 533-9158
NPI assigned
Sep 11, 2019
Sex
Female
Sole proprietor
No

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
2071171TXMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2071171 TX Yes

Addresses

Primary practice location

5934 County Road 289
Sweeny, TX 77480-4024

Mailing address

5934 County Road 289
Sweeny, TX 77480-4024
Phone (979) 533-9158

Other providers in Sweeny, TX

All providers in Sweeny, TX · Physical Therapy Assistant in Texas

Sources for this page

Verify at the official NPI Registry.