Healthcare Provider Details

I. General information

NPI: 1275185449
Provider Name (Legal Business Name): KATHRYN LEE OVERTON DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2019
Last Update Date: 07/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 OAK LAWN AVE STE 670
DALLAS TX
75219-4399
US

IV. Provider business mailing address

1900 MCKINNEY AVE APT 1504
DALLAS TX
75201-1721
US

V. Phone/Fax

Practice location:
  • Phone: 214-528-3378
  • Fax:
Mailing address:
  • Phone: 802-324-1959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: