Healthcare Provider Details

I. General information

NPI: 1033498043
Provider Name (Legal Business Name): JOHN DAVID DEEDS ATP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2011
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

944 MELBOURNE RD
HURST TX
76053-4633
US

IV. Provider business mailing address

944 MELBOURNE RD
HURST TX
76053-4633
US

V. Phone/Fax

Practice location:
  • Phone: 817-589-1110
  • Fax: 817-595-1984
Mailing address:
  • Phone: 817-589-1110
  • Fax: 817-595-1984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225CA2400X
TaxonomyAssistive Technology Practitioner Rehabilitation Counselor
License NumberATP5470
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: