Provider Demographics
NPI:1972256949
Name:DUAMNI, ALIA (PTA)
Entity type:Individual
Prefix:
First Name:ALIA
Middle Name:
Last Name:DUAMNI
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19822 EXCALIBUR CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77094-3469
Mailing Address - Country:US
Mailing Address - Phone:281-818-8615
Mailing Address - Fax:
Practice Address - Street 1:2045 N HWY 360 # 100B
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-1403
Practice Address - Country:US
Practice Address - Phone:972-623-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-31
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2162015225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant