MEDICARE: BOBBYE FRANCENE RANKIN

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	225200000X	Physical Therapy Assistant	2065370	TX

General Provider Information

NPI Number	:	1689154759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BOBBYE FRANCENE RANKIN

Provider Business Mailing Address
First Line	:	109 CR 3544
Second Line	:
City	:	ATLANTA
State	:	TX
Zip	:	75551
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	109 CR 3544
Second Line	:
City	:	ATLANTA
State	:	TX
Zip	:	75551
Country	:	US
Telephone Number	:	903-733-2312
Fax Number	:

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

Provider Enumeration Date	:	08/18/2018
Last Update Date	:	08/18/2018

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