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NPI Code Detail

MEDICARE: MARK CHENEWETH PT

MEDICARE: MARK CHENEWETH PT
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 Therapist1107134TX

General Provider Information

NPI Number : 1265922272
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK CHENEWETH PT
Provider Business Mailing Address
First Line : 2832 BENT OAKS DR
Second Line :
City : BURLESON
State : TX
Zip : 76028-2344
Country : US
Telephone Number : 817-676-6898
Fax Number :
Provider Business Practice Location Address
First Line : 1000 N COOPER ST
Second Line :
City : ARLINGTON
State : TX
Zip : 76011-5540
Country : US
Telephone Number : 817-548-3468
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2018
Last Update Date : 05/15/2018

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Directions to “ MARK CHENEWETH PT” Practice Location

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