MEDICARE: ANDREA BAIRD BREMNER 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	225100000X	Physical Therapist	1313366	TX

General Provider Information

NPI Number	:	1861961104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA BAIRD BREMNER PT, DPT

Provider Business Mailing Address
First Line	:	8081 WALNUT HILL LN STE 130
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-4313
Country	:	US
Telephone Number	:	214-239-0993
Fax Number	:	214-239-0998

Provider Business Practice Location Address
First Line	:	8081 WALNUT HILL LN STE 1000
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-4313
Country	:	US
Telephone Number	:	214-239-0993
Fax Number	:	214-239-0998

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

Provider Enumeration Date	:	11/15/2018
Last Update Date	:	04/12/2021

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