Provider Demographics
NPI:1043946577
Name:SIXTA, ROSLYN JANICE (PTA)
Entity type:Individual
Prefix:
First Name:ROSLYN
Middle Name:JANICE
Last Name:SIXTA
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 1:152 DRESSEN
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-4340
Mailing Address - Country:US
Mailing Address - Phone:979-393-2938
Mailing Address - Fax:
Practice Address - Street 1:4409 GAINES RANCH LOOP
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-6555
Practice Address - Country:US
Practice Address - Phone:512-721-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2170786225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant