=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619941432
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DOUG PAUL SOELL PT, MPT
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/16/2006
-----------------------------------------------------
Last Update Date | 06/03/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3301 SUNDOWN BLVD
-----------------------------------------------------
City | DENTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76210-8032
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 940-387-3700
-----------------------------------------------------
Fax | 940-488-4513
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3301 SUNDOWN BLVD
-----------------------------------------------------
City | DENTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76210-8032
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 940-387-3700
-----------------------------------------------------
Fax | 940-488-4513
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 3783
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 1176807
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------