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NPI Code Detail

MEDICARE: TABITHA ELIZABETH HOGUE PT

MEDICARE: TABITHA ELIZABETH HOGUE 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 Therapist1181467TX

General Provider Information

NPI Number : 1366607715
Entity Type Code : Individual
Provider Name (Legal Business Name) : TABITHA ELIZABETH HOGUE PT
Provider Business Mailing Address
First Line : 966 N GARDEN RIDGE BLVD STE 530
Second Line :
City : LEWISVILLE
State : TX
Zip : 75077-2876
Country : US
Telephone Number : 972-420-6605
Fax Number : 972-436-2770
Provider Business Practice Location Address
First Line : 966 N GARDEN RIDGE BLVD STE 530
Second Line :
City : LEWISVILLE
State : TX
Zip : 75077-2876
Country : US
Telephone Number : 972-420-6605
Fax Number : 972-436-2770
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2008
Last Update Date : 08/22/2014

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Directions to “ TABITHA ELIZABETH HOGUE PT” Practice Location

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