Healthcare Provider Details

I. General information

NPI: 1114979291
Provider Name (Legal Business Name): TERESA BARROW PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 STOCKWELL RD STE 400
BOSSIER CITY LA
71111-7027
US

IV. Provider business mailing address

663 JORDAN ST
SHREVEPORT LA
71101-4748
US

V. Phone/Fax

Practice location:
  • Phone: 318-747-2911
  • Fax: 318-747-8893
Mailing address:
  • Phone: 318-222-8892
  • Fax: 318-222-8893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1169317
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP054644T
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6930
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: