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NPI Code Detail

MEDICARE: TRUDY HODGES BENNETT PTA

MEDICARE: TRUDY HODGES BENNETT PTA
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
1208100000XPhysical Medicine & Rehabilitation Physician2006094TX

General Provider Information

NPI Number : 1104583400
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRUDY HODGES BENNETT PTA
Provider Business Mailing Address
First Line : 2205 SPRINGWOOD LN
Second Line :
City : WEATHERFORD
State : TX
Zip : 76087-3837
Country : US
Telephone Number : 817-455-1319
Fax Number :
Provider Business Practice Location Address
First Line : 401 W ARBROOK BLVD
Second Line :
City : ARLINGTON
State : TX
Zip : 76014-3108
Country : US
Telephone Number : 817-222-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2021
Last Update Date : 11/21/2021

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Directions to “ TRUDY HODGES BENNETT PTA” Practice Location

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