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NPI Code Detail

MEDICARE: SAMANTHA CHEYENNE CHILDRESS DPT

MEDICARE: SAMANTHA CHEYENNE CHILDRESS DPT
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 TherapistCP051723TNC
2225100000XPhysical Therapist15978TN
3225100000XPhysical TherapistCP046454TTX

General Provider Information

NPI Number : 1114759347
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA CHEYENNE CHILDRESS DPT
Provider Business Mailing Address
First Line : 1003 BARREN SPRINGS RD
Second Line :
City : HOLLOW ROCK
State : TN
Zip : 38342-3066
Country : US
Telephone Number : 731-358-9446
Fax Number :
Provider Business Practice Location Address
First Line : 8700 N TARRANT PKWY STE 113
Second Line :
City : NORTH RICHLAND HILLS
State : TX
Zip : 76182-8464
Country : US
Telephone Number : 817-498-8344
Fax Number : 817-498-4008
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2024
Last Update Date : 03/23/2026

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Practice Location Address:
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Practice Fax:
1811236979 — MRS. SARABETH CLOPTON ATKINS PT
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1295174035 — SUDHA MATHAI PT
Practice Location Address:
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1003296922 — AMY WOLF DPT
Practice Location Address:
8700 N TARRANT PKWY , STE 113
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76182-8464
Practice Phone: 817-498-8344
Practice Fax: 817-498-8702

Directions to “ SAMANTHA CHEYENNE CHILDRESS DPT” Practice Location

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