Healthcare Provider Details

I. General information

NPI: 1053377747
Provider Name (Legal Business Name): LINDA L WHITWORTH PT OCS
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: LINDA CLAIRE LEBLANC

II. Dates (important events)

Enumeration Date: 04/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4534 WESTGATE BLVD STE 104 TOWN AND COUNTRY PT
AUSTIN TX
78745
US

IV. Provider business mailing address

1019 SUNDANCE RIDGE RD
DRIPPING SPRINGS TX
78620-4261
US

V. Phone/Fax

Practice location:
  • Phone: 512-892-7337
  • Fax: 512-892-7339
Mailing address:
  • Phone: 512-894-0547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1013886
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: