Provider Demographics
NPI:1114805348
Name:ATHELLI, SNEHA GOUD (PT)
Entity type:Individual
Prefix:
First Name:SNEHA
Middle Name:GOUD
Last Name:ATHELLI
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 1:10507 SMARTY JONES ST
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-5966
Mailing Address - Country:US
Mailing Address - Phone:631-259-1678
Mailing Address - Fax:
Practice Address - Street 1:1729 N CENTRAL EXPY STE A
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-6977
Practice Address - Country:US
Practice Address - Phone:469-786-0005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-25
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1406984225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist