Provider Demographics
NPI:1538603840
Name:WALKER, ANGELA (PT)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25216 GROGANS PARK DR
Mailing Address - Street 2:STE A
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2175
Mailing Address - Country:US
Mailing Address - Phone:281-881-7099
Mailing Address - Fax:
Practice Address - Street 1:25216 GROGANS PARK DR
Practice Address - Street 2:STE A
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-2175
Practice Address - Country:US
Practice Address - Phone:281-881-7099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1176310225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist