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NPI Code Detail

MEDICARE: SCOTT CLIFFORD PRATT PT, DPT

MEDICARE: SCOTT CLIFFORD PRATT PT, 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 Therapist1287287TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1841779139
Entity Type Code : Individual
Provider Name (Legal Business Name) : SCOTT CLIFFORD PRATT PT, DPT
Provider Business Mailing Address
First Line : 3103 SILKWOOD DR
Second Line :
City : TYLER
State : TX
Zip : 75707-2066
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1401 RICE RD
Second Line :
City : TYLER
State : TX
Zip : 75703-3233
Country : US
Telephone Number : 903-561-6060
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2018
Last Update Date : 08/08/2018

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