Provider Demographics
NPI:1336955020
Name:WUELLER, ANNA (PT, DPT)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:WUELLER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 W BLUFF ST
Mailing Address - Street 2:
Mailing Address - City:WOODVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75979-4739
Mailing Address - Country:US
Mailing Address - Phone:409-200-2804
Mailing Address - Fax:409-200-2997
Practice Address - Street 1:1209 W BLUFF ST
Practice Address - Street 2:
Practice Address - City:WOODVILLE
Practice Address - State:TX
Practice Address - Zip Code:75979-4739
Practice Address - Country:US
Practice Address - Phone:409-200-2804
Practice Address - Fax:409-200-2997
Is Sole Proprietor?:No
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1402121225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist