IndividualActive
Jissa Thayil
NPI 1104306257 · Geriatric Physical Therapist · Georgetown, TX
Provider details
- NPI number
- 1104306257
- Entity type
- Individual
- Primary specialty
- Geriatric Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 1165213 (TX)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
2406 Brookhollow Ter
Georgetown, TX 78626-7684
Phone: (183) 262-0316
Approximate (ZIP-level) locationGet directions
Mailing address
2406 Brookhollow Ter
Georgetown, TX 78626-7684
Registry dates
- Enumerated
- 2018-08-17
- Last updated
- 2018-08-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.