MEDICARE: MRS. STEPHANIE MCCOY IRIZARRY PT CWS RMT MLT

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	225100000X	Physical Therapist	1094530	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8T2846	OTHER	TX	BCBS ID

General Provider Information

NPI Number	:	1275603755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. STEPHANIE MCCOY IRIZARRY PT CWS RMT MLT

Provider Business Mailing Address
First Line	:	1248 HARWOOD RD
Second Line	:
City	:	BEDFORD
State	:	TX
Zip	:	76021-4244
Country	:	US
Telephone Number	:	817-786-8058
Fax Number	:	817-786-8057

Provider Business Practice Location Address
First Line	:	1248 HARWOOD RD
Second Line	:
City	:	BEDFORD
State	:	TX
Zip	:	76021-4244
Country	:	US
Telephone Number	:	817-786-8058
Fax Number	:	817-786-8057

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

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	01/09/2026

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