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General NPI Number Information
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NPI Number | 1245658244
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Entity Type | Individual
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Provider Name | PAUL LEROY RETCOFSKY A.T.P.
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Gender | Male
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Dates
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Enumeration Date | 04/07/2014
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 2631 GRAVEL DR
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City | FORT WORTH
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State | TX
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Zip | 76118-6982
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Country | US
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Telephone | 972-647-0111
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Fax | 972-647-0040
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Provider Business Mailing Address
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Address Line | 2631 GRAVEL DR
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City | FORT WORTH
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State | TX
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Zip | 76118-6982
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Country | US
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Telephone | 972-647-0111
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Fax | 972-647-0040
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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 | 225CA2400X
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Taxonomy Name | Assistive Technology Practitioner Rehabilitation Counselor
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License Number | ATP69819
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License Number State | TX
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