Healthcare Provider Details

I. General information

NPI: 1912312281
Provider Name (Legal Business Name): MAGGIE CAPPEL PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2014
Last Update Date: 06/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

1410 S GOLIAD ST APT 1705
ROCKWALL TX
75087
US

V. Phone/Fax

Practice location:
  • Phone: 214-528-3378
  • Fax: 214-528-3379
Mailing address:
  • Phone: 317-997-2036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3116102
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: