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NPI Code Detail

MEDICARE: ZACHARY L HETTLER PT, DPT, LAT, ATC

MEDICARE: ZACHARY L HETTLER PT, DPT, LAT, ATC
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
12255A2300XAthletic Trainer2000050914
2225100000XPhysical Therapist1397063TX

General Provider Information

NPI Number : 1588145247
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZACHARY L HETTLER PT, DPT, LAT, ATC
Provider Business Mailing Address
First Line : 6101 WINDHAVEN PKWY STE 145
Second Line :
City : PLANO
State : TX
Zip : 75093-8198
Country : US
Telephone Number : 972-473-8980
Fax Number :
Provider Business Practice Location Address
First Line : 6101 WINDHAVEN PKWY STE 145
Second Line :
City : PLANO
State : TX
Zip : 75093-8198
Country : US
Telephone Number : 972-473-8980
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2018
Last Update Date : 10/13/2025

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