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General NPI Number Information
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NPI Number | 1346659273
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Entity Type | Individual
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Provider Name | ELIZABETH DIXON P.T.A.
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Gender | Female
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Dates
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Enumeration Date | 08/05/2014
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Last Update Date | 08/05/2014
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Provider Practice Location Address
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Address Line | 6130 PARKWAY
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City | CORPUS CHRISTI
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State | TX
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Zip | 78414-2455
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Country | US
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Telephone | 361-826-5779
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Fax |
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Provider Business Mailing Address
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Address Line | 9350 S PADRE ISLAND DR SUITE 113
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City | CORPUS CHRISTI
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State | TX
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Zip | 78418-5519
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Country | US
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Telephone | 330-472-0372
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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 | 2104499
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License Number State | TX
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