Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Cheryl Tirtowidjojo

Individual provider Athletic Trainer · NPI 1346839719

Cheryl Tirtowidjojo is an Athletic Trainer in Lake Jackson, Texas. Practices as a sole proprietor. Registered with an NPI since 2021.

In the registry since
2021

Practice location Address checks out

110 Rosewood St
Lake Jackson, TX 77566-4937
Phone: (979) 665-5953
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X

Record details

NPI number1346839719
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 11, 2021
Last updated in NPPESJanuary 11, 2021
Certification dateJanuary 11, 2021

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