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NPI Code Detail

MEDICARE: ELAINE RENAE SIGLEY PTA

MEDICARE: ELAINE RENAE SIGLEY PTA
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
1225200000XPhysical Therapy Assistant2058939TX

General Provider Information

NPI Number : 1770600595
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELAINE RENAE SIGLEY PTA
Provider Business Mailing Address
First Line : 14000 NOEL RD APT 319
Second Line :
City : DALLAS
State : TX
Zip : 75240-7325
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9441 LYNDON B JOHNSON FWY STE 101
Second Line :
City : DALLAS
State : TX
Zip : 75243-4566
Country : US
Telephone Number : 866-575-9820
Fax Number : 214-575-9820
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2007
Last Update Date : 07/08/2007

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Directions to “ ELAINE RENAE SIGLEY PTA” Practice Location

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