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General NPI Number Information
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NPI Number | 1740727726
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Entity Type | Organization
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Legal Business Name | NORTH TEXAS PHYSIATRY P.A.
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Dates
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Enumeration Date | 01/27/2017
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Last Update Date | 02/22/2021
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Provider Practice Location Address
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Address Line | 7777 FOREST LN
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City | DALLAS
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State | TX
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Zip | 75230
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Country | US
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Telephone | 972-566-7000
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Fax | 817-284-3425
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Provider Business Mailing Address
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Address Line | PO BOX 678708
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City | DALLAS
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State | TX
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Zip | 75267-8708
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Country | US
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Telephone | 817-284-9850
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Fax | 817-284-3425
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | KATHLEEN VAWTER
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Credential |
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Telephone | 801-388-7745
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | N3145
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License Number State | TX
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