MEDICARE: KAREN VAVRIN 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
1	225100000X	Physical Therapist	1024099	TX

General Provider Information

NPI Number	:	1275864084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN VAVRIN LPT

Provider Business Mailing Address
First Line	:	2225 E RANDOL MILL RD
Second Line	:	101
City	:	ARLINGTON
State	:	TX
Zip	:	76011-6315
Country	:	US
Telephone Number	:	817-274-1200
Fax Number	:	817-274-1299

Provider Business Practice Location Address
First Line	:	2225 E RANDOL MILL RD
Second Line	:	101
City	:	ARLINGTON
State	:	TX
Zip	:	76011-6315
Country	:	US
Telephone Number	:	817-274-1200
Fax Number	:	817-274-1299

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2010
Last Update Date	:	01/18/2010

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Directions to “ KAREN VAVRIN LPT” Practice Location

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