Healthcare Provider Details

I. General information

NPI: 1538541974
Provider Name (Legal Business Name): CARLING E BUTLER PT, DPT, MSCI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2015
Last Update Date: 06/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3131 TURTLE CREEK BLVD #615
DALLAS TX
75219-5405
US

IV. Provider business mailing address

1855 PAYNE ST #640
DALLAS TX
75201-1746
US

V. Phone/Fax

Practice location:
  • Phone: 214-528-3378
  • Fax:
Mailing address:
  • Phone: 708-828-1412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1232088
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: