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NPI Code Detail

MEDICARE: AMY PCHINOW PTA

MEDICARE: AMY PCHINOW PTA
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
1225200000XPhysical Therapy Assistant2137880TX

General Provider Information

NPI Number : 1891261558
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY PCHINOW PTA
Provider Business Mailing Address
First Line : 4736 KENDRICK PEAK WAY
Second Line :
City : FT WORTH
State : TX
Zip : 76244-2025
Country : US
Telephone Number : 941-345-9591
Fax Number :
Provider Business Practice Location Address
First Line : 2600 PARKVIEW LN
Second Line :
City : BEDFORD
State : TX
Zip : 76022-7989
Country : US
Telephone Number : 817-864-8753
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2018
Last Update Date : 10/22/2018

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