Healthcare Provider Details

I. General information

NPI: 1366980393
Provider Name (Legal Business Name): SARAH LAYNE CUMBIE PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2017
Last Update Date: 02/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 N WASHINGTON AVE STE 5000
DALLAS TX
75246-1792
US

IV. Provider business mailing address

2828 LEMMON AVE APT 3114
DALLAS TX
75204-3735
US

V. Phone/Fax

Practice location:
  • Phone: 214-820-9375
  • Fax:
Mailing address:
  • Phone: 325-338-5407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1286581
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: