Provider Demographics
NPI:1295273225
Name:BIST, AKANKSHA (DPT, PT)
Entity type:Individual
Prefix:
First Name:AKANKSHA
Middle Name:
Last Name:BIST
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2521 GOLDEN GATE PARK
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78732-2422
Mailing Address - Country:US
Mailing Address - Phone:940-782-1914
Mailing Address - Fax:
Practice Address - Street 1:2521 GOLDEN GATE PARK
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78732-2422
Practice Address - Country:US
Practice Address - Phone:940-782-1914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-10
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1225997225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist