Healthcare Provider Details

I. General information

NPI: 1992459879
Provider Name (Legal Business Name): CAREN BETZ PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2022
Last Update Date: 02/09/2022
Certification Date: 02/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8017 MESA DR
AUSTIN TX
78731-1300
US

IV. Provider business mailing address

7503 JESTER BLVD
AUSTIN TX
78750-7923
US

V. Phone/Fax

Practice location:
  • Phone: 512-791-3702
  • Fax: 512-682-0220
Mailing address:
  • Phone: 512-579-6420
  • Fax: 512-682-0220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number1097582
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: