Provider Demographics
NPI:1548048234
Name:GOHEL, ANITA
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:GOHEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15849 TERENWOOD ST
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-9434
Mailing Address - Country:US
Mailing Address - Phone:717-315-2100
Mailing Address - Fax:
Practice Address - Street 1:3700 W 15TH ST STE 200
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-4736
Practice Address - Country:US
Practice Address - Phone:972-867-7675
Practice Address - Fax:972-985-1788
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-15
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1384190225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist