MEDICARE: HEATHER DAVIS CRUZ GUIDO PT, DPT

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	261QP2000X	Physical Therapy Clinic/Center	3132905	TX
2	261QP2000X	Physical Therapy Clinic/Center	1396578	TX

General Provider Information

NPI Number	:	1629810957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER DAVIS CRUZ GUIDO PT, DPT

Provider Business Mailing Address
First Line	:	2845 RANGER LN
Second Line	:
City	:	AUBREY
State	:	TX
Zip	:	76227-3136
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4210 MESA DR
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76207-3458
Country	:	US
Telephone Number	:	940-320-6219
Fax Number	:

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

Provider Enumeration Date	:	06/07/2024
Last Update Date	:	08/26/2024

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