Healthcare Provider Details

I. General information

NPI: 1063293900
Provider Name (Legal Business Name): SAMANTHA YORKE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2023
Last Update Date: 10/06/2023
Certification Date: 10/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 W WILLIAM CANNON DR
AUSTIN TX
78745-5257
US

IV. Provider business mailing address

3101 S LAMAR BLVD APT 1402
AUSTIN TX
78704-5860
US

V. Phone/Fax

Practice location:
  • Phone: 512-852-8434
  • Fax:
Mailing address:
  • Phone: 360-791-5228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: