Provider Demographics
NPI:1154874592
Name:SHETH, NEIL BIPIN (PT, DPT, CSCS)
Entity type:Individual
Prefix:DR
First Name:NEIL
Middle Name:BIPIN
Last Name:SHETH
Suffix:
Gender:M
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 RAGING RIVER RD
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-3171
Mailing Address - Country:US
Mailing Address - Phone:201-723-6220
Mailing Address - Fax:
Practice Address - Street 1:1904 S BAGDAD RD STE 4
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-2866
Practice Address - Country:US
Practice Address - Phone:585-708-9242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-02
Last Update Date:2022-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1282771225100000X
NJ225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist