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NPI Code Detail

MEDICARE: MARK ANTHONY LINANE PT, MS

MEDICARE: MARK ANTHONY LINANE PT, MS
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
12251X0800XOrthopedic Physical Therapist1059822TX
2225100000XPhysical Therapist1059822TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
185589TOTHERTXBLUE CROSS BLUE SHIELD
2854T82OTHERTXBC/BS TX - EFFECT. 02/01/2011
34363236OTHERTXAETNA HEALTHCARE

General Provider Information

NPI Number : 1700854304
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK ANTHONY LINANE PT, MS
Provider Business Mailing Address
First Line : 1125 RAINTREE CIR STE 100
Second Line :
City : ALLEN
State : TX
Zip : 75013-5289
Country : US
Telephone Number : 972-727-9995
Fax Number : 972-727-8350
Provider Business Practice Location Address
First Line : 1125 RAINTREE CIR STE 100
Second Line :
City : ALLEN
State : TX
Zip : 75013-5289
Country : US
Telephone Number : 972-727-9995
Fax Number : 972-727-8350
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2006
Last Update Date : 04/01/2019

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Directions to “ MARK ANTHONY LINANE PT, MS” Practice Location

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