Provider Demographics
NPI:1215146394
Name:ALBERTSON, SHERI (PT)
Entity type:Individual
Prefix:
First Name:SHERI
Middle Name:
Last Name:ALBERTSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SHERI
Other - Middle Name:
Other - Last Name:SHIPLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:4303 VICTORY DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-7507
Mailing Address - Country:US
Mailing Address - Phone:512-250-9140
Mailing Address - Fax:
Practice Address - Street 1:5004 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78732-1719
Practice Address - Country:US
Practice Address - Phone:512-250-9140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1079945225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX100616501Medicaid
TXP00244128OtherRAILROAD MEDICARE
TX801T88OtherBLUE CROSS
TX100616502Medicaid
TX801T86OtherBLUE CROSS
TXP00244128OtherRAILROAD MEDICARE
TX100616502Medicaid