Healthcare Provider Details

I. General information

NPI: 1417678434
Provider Name (Legal Business Name): SAMANTHA DANIELLE GARCIA PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SAMANTHA DANIELLE GOMEZ

II. Dates (important events)

Enumeration Date: 09/07/2022
Last Update Date: 09/07/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N COOPER ST
ARLINGTON TX
76011-5540
US

IV. Provider business mailing address

2303 EMBRY PL APT 1604
FORT WORTH TX
76111-1465
US

V. Phone/Fax

Practice location:
  • Phone: 817-548-3400
  • Fax:
Mailing address:
  • Phone: 956-244-5121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1364184
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: