Healthcare Provider Details

I. General information

NPI: 1427296888
Provider Name (Legal Business Name): DEIRDRE M DEIGNAN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2009
Last Update Date: 01/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9441 LBJ FWY SUITE 101
DALLAS TX
75243-4545
US

IV. Provider business mailing address

6015 VELASCO AVE
DALLAS TX
75206-6331
US

V. Phone/Fax

Practice location:
  • Phone: 214-575-9820
  • Fax:
Mailing address:
  • Phone: 469-688-1484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1160610
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: