Provider Demographics
NPI:1215316211
Name:HAYDE, ALISON LAUREN (PT)
Entity type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:LAUREN
Last Name:HAYDE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:ALISON
Other - Middle Name:LAUREN
Other - Last Name:WOLFGANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:5718 SPOHN DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414
Mailing Address - Country:US
Mailing Address - Phone:361-906-2062
Mailing Address - Fax:361-906-2063
Practice Address - Street 1:5718 SPOHN DR
Practice Address - Street 2:SUITE 200
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414
Practice Address - Country:US
Practice Address - Phone:361-906-2062
Practice Address - Fax:361-906-2063
Is Sole Proprietor?:No
Enumeration Date:2015-05-22
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60550434225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist