Provider Demographics
NPI:1528799830
Name:MOMIN, NADIYA (PTA)
Entity type:Individual
Prefix:
First Name:NADIYA
Middle Name:
Last Name:MOMIN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8421 WILLOW LOCH DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-7551
Mailing Address - Country:US
Mailing Address - Phone:100-000-0000
Mailing Address - Fax:
Practice Address - Street 1:5600 CYPRESSWOOD DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-8691
Practice Address - Country:US
Practice Address - Phone:284-767-2715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-19
Last Update Date:2022-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant