MEDICARE: CERDA PEDIATRIC & NEURO PHYSICAL THERAPY PLLC

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1801664073
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CERDA PEDIATRIC & NEURO PHYSICAL THERAPY PLLC

Provider Business Mailing Address
First Line	:	7824 LANDERS LN
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76135-9007
Country	:	US
Telephone Number	:	214-587-4994
Fax Number	:

Provider Business Practice Location Address
First Line	:	7824 LANDERS LN
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76135-9007
Country	:	US
Telephone Number	:	214-587-4994
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DIRECTOR
Name	:	DR. CATHY VENEGAS CERDA
Credential	:	DPT
Telephone Number	:	214-587-4994

Provider Enumeration Date	:	12/18/2023
Last Update Date	:	12/19/2023

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