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NPI Code Detail

MEDICARE: SHELBY CELESTE PANZINO

MEDICARE: SHELBY CELESTE PANZINO
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 Therapist3119027TX

General Provider Information

NPI Number : 1336598382
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELBY CELESTE PANZINO
Provider Business Mailing Address
First Line : 3824 S CARRIER PKWY
Second Line : STE 470
City : GRAND PRAIRIE
State : TX
Zip : 75052-6644
Country : US
Telephone Number : 972-262-9972
Fax Number : 972-262-9986
Provider Business Practice Location Address
First Line : 160 W MAGNOLIA AVE STE 2
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-7613
Country : US
Telephone Number : 817-335-7946
Fax Number : 817-335-7947
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2016
Last Update Date : 11/26/2021

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Directions to “ SHELBY CELESTE PANZINO ” Practice Location

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