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General NPI Number Information
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NPI Number | 1508777137
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Entity Type | Individual
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Provider Name | DEANNA L LUSTY PT, MPT, ATP/SMS
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Gender | Female
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Dates
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Enumeration Date | 09/14/2026
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Last Update Date | 09/14/2026
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Provider Practice Location Address
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Address Line | 2222 MEDICAL DISTRICT DR STE 210
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City | DALLAS
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State | TX
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Zip | 75235-8075
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Country | US
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Telephone | 214-867-6985
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Fax |
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Provider Business Mailing Address
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Address Line | 410 PARKWOOD LN
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City | COPPELL
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State | TX
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Zip | 75019-6025
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Country | US
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Telephone | 972-989-9100
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 1172599
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License Number State | TX
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