Provider Demographics
NPI:1992546436
Name:BENNETT NORMAN, ANIFEL QUIJANO
Entity type:Individual
Prefix:
First Name:ANIFEL
Middle Name:QUIJANO
Last Name:BENNETT NORMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21207 BARKER CANYON LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-6904
Mailing Address - Country:US
Mailing Address - Phone:281-901-7512
Mailing Address - Fax:
Practice Address - Street 1:770 BROOKS ST
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4632
Practice Address - Country:US
Practice Address - Phone:281-968-5707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2116815225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant