MEDICARE: GEORGE ALAN SUMMERS MPT

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	PT6697	OH
2	225100000X	Physical Therapist	1338368	TX

General Provider Information

NPI Number	:	1821025248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE ALAN SUMMERS MPT

Provider Business Mailing Address
First Line	:	8412 DAVIS BLVD STE 190
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76182-8679
Country	:	US
Telephone Number	:	817-479-7168
Fax Number	:	817-479-3498

Provider Business Practice Location Address
First Line	:	8412 DAVIS BLVD STE 190
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76182-8679
Country	:	US
Telephone Number	:	817-479-7168
Fax Number	:	330-479-3498

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

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	02/06/2024

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Directions to “ GEORGE ALAN SUMMERS MPT” Practice Location

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