Basic Information
Provider Information
NPI: 1083205991
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AGGARWAL
FirstName: SONALI
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 2650
Address2:  
City: COPPELL
State: TX
PostalCode: 750198607
CountryCode: US
TelephoneNumber: 9727242400
FaxNumber: 9727242495
Practice Location
Address1: 12520 WILLOW SPRINGS RD
Address2: BLDG 3, STE 104
City: HASLET
State: TX
PostalCode: 76052
CountryCode: US
TelephoneNumber: 8172106196
FaxNumber: 8177829303
Other Information
ProviderEnumerationDate: 02/02/2021
LastUpdateDate: 02/02/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/18/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X1335797TXY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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