Healthcare Provider Details

I. General information

NPI: 1396212312
Provider Name (Legal Business Name): KAREN ANN TRAVERS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2018
Last Update Date: 04/20/2021
Certification Date: 04/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 N WASHINGTON AVE
DALLAS TX
75246-1520
US

IV. Provider business mailing address

10316 ESTATE LN
DALLAS TX
75238-2209
US

V. Phone/Fax

Practice location:
  • Phone: 214-820-9000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1124105
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: