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NPI Code Detail

MEDICARE: BROCK WALKER

MEDICARE:   BROCK  WALKER
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
1225700000XMassage TherapistMT139764TX

General Provider Information

NPI Number : 1093526238
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROCK WALKER
Provider Business Mailing Address
First Line : 900 FRANCES WAY APT 328
Second Line :
City : RICHARDSON
State : TX
Zip : 75081-4351
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 900 FRANCES WAY APT 328
Second Line :
City : RICHARDSON
State : TX
Zip : 75081-4351
Country : US
Telephone Number : 903-949-1588
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2025
Last Update Date : 01/16/2025

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Directions to “ BROCK WALKER ” Practice Location

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