MEDICARE: MRS. CHRISTINA NICOLE FAUBER PT, DPT

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
1	2251P0200X	Pediatric Physical Therapist	1239789	TX

General Provider Information

NPI Number	:	1093128829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTINA NICOLE FAUBER PT, DPT

Provider Business Mailing Address
First Line	:	930 W CENTERVILLE RD # 930C
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75041-5823
Country	:	US
Telephone Number	:	972-303-8021
Fax Number	:	972-303-7020

Provider Business Practice Location Address
First Line	:	930 W CENTERVILLE RD # 930C
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75041-5823
Country	:	US
Telephone Number	:	972-303-8021
Fax Number	:	972-303-7020

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2014
Last Update Date	:	06/10/2014

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