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NPI Code Detail

MEDICARE: DR. HAVILAND SYNCLAIRE BLEVINS PT, DPT

MEDICARE: DR. HAVILAND SYNCLAIRE BLEVINS 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
12251P0200XPediatric Physical Therapist1408480TX

General Provider Information

NPI Number : 1912832080
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HAVILAND SYNCLAIRE BLEVINS PT, DPT
Provider Business Mailing Address
First Line : 1733 CATTAIL CREEK DR
Second Line :
City : DESOTO
State : TX
Zip : 75115-1720
Country : US
Telephone Number : 214-450-2368
Fax Number :
Provider Business Practice Location Address
First Line : 1431 GREENWAY DR STE 500
Second Line :
City : IRVING
State : TX
Zip : 75038-2444
Country : US
Telephone Number : 214-450-2368
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2026
Last Update Date : 06/17/2026

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