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General NPI Number Information
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NPI Number | 1336717958
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Entity Type | Individual
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Provider Name | FRANCES FENNELL
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Gender | Female
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Dates
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Enumeration Date | 06/11/2021
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Last Update Date | 06/11/2021
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Provider Practice Location Address
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Address Line | 4230 LYNDON B JOHNSON FWY STE 413
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City | DALLAS
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State | TX
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Zip | 75244-5805
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Country | US
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Telephone | 469-708-3954
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Fax |
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Provider Business Mailing Address
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Address Line | 4109 KITE LN
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City | MANSFIELD
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State | TX
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Zip | 76063-3498
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Country | US
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Telephone | 469-583-1969
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State | TX
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