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NPI Code Detail

MEDICARE: DR. EMILY KATHERINE SURGEONER DPT

MEDICARE: DR. EMILY KATHERINE SURGEONER 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
12251S0007XSports Physical TherapistTX

General Provider Information

NPI Number : 1922798776
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EMILY KATHERINE SURGEONER DPT
Provider Business Mailing Address
First Line : 2111 AUTUMN COVE CIR
Second Line :
City : FLEMING ISLAND
State : FL
Zip : 32003-3231
Country : US
Telephone Number : 904-524-1487
Fax Number :
Provider Business Practice Location Address
First Line : 23910 KATY FWY
Second Line :
City : KATY
State : TX
Zip : 77494-1395
Country : US
Telephone Number : 281-500-6100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2023
Last Update Date : 05/15/2023

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