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NPI Code Detail

MEDICARE: CAROLYN FARMER PT

MEDICARE:   CAROLYN  FARMER  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 Therapist1134377TX

General Provider Information

NPI Number : 1386754653
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLYN FARMER PT
Provider Business Mailing Address
First Line : 6037 HARRIS PKWY
Second Line :
City : FORT WORTH
State : TX
Zip : 76132-4103
Country : US
Telephone Number : 817-370-9891
Fax Number : 817-370-9894
Provider Business Practice Location Address
First Line : 4625 BOAT CLUB RD
Second Line :
City : FORT WORTH
State : TX
Zip : 76135-7022
Country : US
Telephone Number : 817-238-9295
Fax Number : 817-238-9299
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 07/08/2007

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