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NPI Code Detail

MEDICARE: RICHARD DEAN ASHLOCK PT

MEDICARE:   RICHARD DEAN ASHLOCK  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 Therapist1161450TX

General Provider Information

NPI Number : 1194825026
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD DEAN ASHLOCK PT
Provider Business Mailing Address
First Line : 7312 ANDREA CT
Second Line :
City : NORTH RICHLAND HILLS
State : TX
Zip : 76180-4544
Country : US
Telephone Number : 817-581-0682
Fax Number :
Provider Business Practice Location Address
First Line : 1109 8TH AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-4102
Country : US
Telephone Number : 817-338-4220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2006
Last Update Date : 07/08/2007

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Directions to “ RICHARD DEAN ASHLOCK PT” Practice Location

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