Healthcare Provider Details

I. General information

NPI: 1053524181
Provider Name (Legal Business Name): JAMES ALLEN HARDIN PT, SCS, ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 08/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5806 BUCKPASSER CV
AUSTIN TX
78746-1450
US

IV. Provider business mailing address

5806 BUCKPASSER CV
AUSTIN TX
78746-1450
US

V. Phone/Fax

Practice location:
  • Phone: 512-232-5057
  • Fax:
Mailing address:
  • Phone: 512-232-5057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number1112605
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT1812
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: