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NPI Code Detail

MEDICARE: SANDRA L SEAWELL LPT

MEDICARE:   SANDRA L SEAWELL  LPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist1062487TX
22251G0304XGeriatric Physical Therapist1062487TX
32251N0400XNeurology Physical Therapist1062487TX
42251P0200XPediatric Physical Therapist1062487TX

General Provider Information

NPI Number : 1083859136
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA L SEAWELL LPT
Provider Business Mailing Address
First Line : 3550 HULEN ST
Second Line : STE D
City : FORT WORTH
State : TX
Zip : 76107-6808
Country : US
Telephone Number : 817-377-2535
Fax Number : 817-292-0572
Provider Business Practice Location Address
First Line : 3550 HULEN ST
Second Line : STE D
City : FORT WORTH
State : TX
Zip : 76107-6808
Country : US
Telephone Number : 817-377-2535
Fax Number : 817-292-0572
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2008
Last Update Date : 12/03/2008

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Directions to “ SANDRA L SEAWELL LPT” Practice Location

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