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NPI Code Detail

MEDICARE: SAMANTHA RUTH EWING PT

MEDICARE: SAMANTHA RUTH EWING PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist1323034TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11323034OTHERTXPT

General Provider Information

NPI Number : 1013537026
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA RUTH EWING PT
Provider Business Mailing Address
First Line : 320 CUSTER RD
Second Line :
City : RICHARDSON
State : TX
Zip : 75080-5623
Country : US
Telephone Number : 972-490-9055
Fax Number : 972-490-9058
Provider Business Practice Location Address
First Line : 10640 N RIVERSIDE DR STE 200
Second Line :
City : FORT WORTH
State : TX
Zip : 76244-9506
Country : US
Telephone Number : 817-431-9000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2020
Last Update Date : 11/12/2025

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