MEDICARE: DARNELL CHARLES 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	PT40661	FL
2	225100000X	Physical Therapist	1390822	TX
3	225100000X	Physical Therapist	307408	CA
4	225100000X	Physical Therapist	12055	SC

General Provider Information

NPI Number	:	1922861558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARNELL CHARLES DPT

Provider Business Mailing Address
First Line	:	2999 OLYMPUS BLVD STE 500
Second Line	:
City	:	COPPELL
State	:	TX
Zip	:	75019-1205
Country	:	US
Telephone Number	:	866-871-8519
Fax Number	:

Provider Business Practice Location Address
First Line	:	2999 OLYMPUS BLVD STE 500
Second Line	:
City	:	COPPELL
State	:	TX
Zip	:	75019-1205
Country	:	US
Telephone Number	:	866-871-8519
Fax Number	:

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

Provider Enumeration Date	:	02/05/2024
Last Update Date	:	02/03/2026

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Directions to “ DARNELL CHARLES DPT” Practice Location

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