Provider Demographics
NPI:1619518966
Name:JAVIER-ANDERSON, PRINCESS ERIKA
Entity type:Individual
Prefix:
First Name:PRINCESS
Middle Name:ERIKA
Last Name:JAVIER-ANDERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PRINCESS
Other - Middle Name:E
Other - Last Name:JAVIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15265 CHESHIRE WAY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-2372
Mailing Address - Country:US
Mailing Address - Phone:210-292-5040
Mailing Address - Fax:
Practice Address - Street 1:1100 WILFORD HALL LOOP
Practice Address - Street 2:
Practice Address - City:JBSA LACKLAND
Practice Address - State:TX
Practice Address - Zip Code:78236-5638
Practice Address - Country:US
Practice Address - Phone:210-292-5040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-07
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2118627225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant