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NPI Code Detail

MEDICARE: MRS. JULIA LEA POTTER PT

MEDICARE: MRS. JULIA LEA POTTER 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 Therapist1089241TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18T604401OTHERTXBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588736615
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JULIA LEA POTTER PT
Provider Business Mailing Address
First Line : 13 OLD TRAHAN PL
Second Line :
City : LUMBERTON
State : TX
Zip : 77657-7013
Country : US
Telephone Number : 409-466-4514
Fax Number : 409-227-4717
Provider Business Practice Location Address
First Line : 101 CANYON LAKE CIR
Second Line :
City : LUMBERTON
State : TX
Zip : 77657-3701
Country : US
Telephone Number : 409-466-4514
Fax Number : 409-227-4717
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2006
Last Update Date : 02/23/2026

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