Provider Demographics
NPI:1023721008
Name:SIEGUE, ANN CARMEL PADILLO (PT)
Entity type:Individual
Prefix:MRS
First Name:ANN CARMEL
Middle Name:PADILLO
Last Name:SIEGUE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4218 CHLOE RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77441-2266
Mailing Address - Country:US
Mailing Address - Phone:346-715-0364
Mailing Address - Fax:
Practice Address - Street 1:4218 CHLOE RIDGE LN
Practice Address - Street 2:
Practice Address - City:FULSHEAR
Practice Address - State:TX
Practice Address - Zip Code:77441-2266
Practice Address - Country:US
Practice Address - Phone:346-715-0364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1289816225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist