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NPI Code Detail

MEDICARE: CARTER HAILEY KANGERGA D.P.T.

MEDICARE: CARTER HAILEY KANGERGA D.P.T.
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 Therapist1226842TX

General Provider Information

NPI Number : 1326387895
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARTER HAILEY KANGERGA D.P.T.
Provider Business Mailing Address
First Line : 520 FIELDER NORTH PLZ
Second Line :
City : ARLINGTON
State : TX
Zip : 76012-2309
Country : US
Telephone Number : 817-461-4257
Fax Number : 817-461-4865
Provider Business Practice Location Address
First Line : 520 FIELDER NORTH PLZ
Second Line :
City : ARLINGTON
State : TX
Zip : 76012-2309
Country : US
Telephone Number : 817-461-4257
Fax Number : 817-461-4865
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2013
Last Update Date : 02/10/2017

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