Healthcare Provider Details

I. General information

NPI: 1922219054
Provider Name (Legal Business Name): CATHERINE JEAN CURRIER-BUCKINGHAM PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 7TH AVE
FORT WORTH TX
76104-2733
US

IV. Provider business mailing address

604 S DURANGO CIR
IRVING TX
75062-6522
US

V. Phone/Fax

Practice location:
  • Phone: 682-885-4064
  • Fax: 682-885-1878
Mailing address:
  • Phone: 972-650-0944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1013043
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: