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General NPI Number Information
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NPI Number | 1114759347
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Entity Type | Individual
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Provider Name | SAMANTHA CHEYENNE CHILDRESS DPT
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Gender | Female
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Dates
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Enumeration Date | 08/16/2024
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 8700 N TARRANT PKWY STE 113
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City | NORTH RICHLAND HILLS
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State | TX
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Zip | 76182-8464
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Country | US
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Telephone | 817-498-8344
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Fax | 817-498-4008
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Provider Business Mailing Address
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Address Line | 1003 BARREN SPRINGS RD
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City | HOLLOW ROCK
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State | TN
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Zip | 38342-3066
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Country | US
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Telephone | 731-358-9446
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 15978
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP038846T
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP046454T
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License Number State | TX
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