Provider Demographics
NPI:1831808955
Name:HEDT, BIANCA (PT)
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:
Last Name:HEDT
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 1:67 ASBURY PARK
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2830
Mailing Address - Country:US
Mailing Address - Phone:713-724-9290
Mailing Address - Fax:
Practice Address - Street 1:1111 HIGHWAY 6 STE 195
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4959
Practice Address - Country:US
Practice Address - Phone:832-658-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1246879225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist