Healthcare Provider Details

I. General information

NPI: 1346601861
Provider Name (Legal Business Name): ELIZABETH LAUREN HUFFMAN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2016
Last Update Date: 01/19/2021
Certification Date: 01/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4825 ALLIANCE BLVD STE 200
PLANO TX
75093-5504
US

IV. Provider business mailing address

3328 DORADO BEACH DR
FARMERS BRANCH TX
75234-2208
US

V. Phone/Fax

Practice location:
  • Phone: 469-606-1378
  • Fax:
Mailing address:
  • Phone: 501-580-7226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1250591
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: