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NPI Code Detail

MEDICARE: SHAE PHILLIPS DPT

MEDICARE:   SHAE  PHILLIPS  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
1225100000XPhysical Therapist1240146TX

General Provider Information

NPI Number : 1538583828
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAE PHILLIPS DPT
Provider Business Mailing Address
First Line : 141 COLLEGE PARK DR
Second Line :
City : WEATHERFORD
State : TX
Zip : 76086-5653
Country : US
Telephone Number : 817-341-3600
Fax Number : 817-599-8181
Provider Business Practice Location Address
First Line : 141 COLLEGE PARK DR
Second Line :
City : WEATHERFORD
State : TX
Zip : 76086-5653
Country : US
Telephone Number : 817-341-3600
Fax Number : 817-599-8181
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2014
Last Update Date : 02/07/2014

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Directions to “ SHAE PHILLIPS DPT” Practice Location

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