Healthcare Provider Details

I. General information

NPI: 1861793630
Provider Name (Legal Business Name): BRANDY HEJL PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2010
Last Update Date: 03/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2074 ANTILLEY RD
ABILENE TX
79606-5209
US

IV. Provider business mailing address

2074 ANTILLEY RD
ABILENE TX
79606-5209
US

V. Phone/Fax

Practice location:
  • Phone: 325-670-9700
  • Fax:
Mailing address:
  • Phone: 325-670-9700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1178268
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: