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General NPI Number Information
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NPI Number | 1134628134
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Entity Type | Individual
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Provider Name | TREVOR ROBERT CONANT PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 02/05/2018
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Last Update Date | 02/05/2018
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Provider Practice Location Address
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Address Line | 7616 LBJ FWY STE 640
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City | DALLAS
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State | TX
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Zip | 75251-1184
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Country | US
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Telephone | 214-960-4038
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Fax |
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Provider Business Mailing Address
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Address Line | 43 PAMELA LN
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City | COLLEGE STATION
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State | TX
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Zip | 77845-9446
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Country | US
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Telephone | 979-587-1189
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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 | 13011390
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License Number State |
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