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NPI Code Detail

MEDICARE: MR. WILLIAM THOMAS LUTZ JR. P.T.

MEDICARE: MR. WILLIAM THOMAS LUTZ JR. P.T.
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
1225100000XPhysical Therapist1034239TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18T1320OTHERTXBCBS
27805686OTHERTXAETNA PROVIDER NUMBER
37369407OTHERTXBCBS BLUELINK

General Provider Information

NPI Number : 1942320874
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. WILLIAM THOMAS LUTZ JR. P.T.
Provider Business Mailing Address
First Line : 1101 OHIO DR
Second Line : STE 105
City : PLANO
State : TX
Zip : 75093-5331
Country : US
Telephone Number : 972-420-6605
Fax Number : 972-436-2770
Provider Business Practice Location Address
First Line : 966 N GARDEN RIDGE BLVD STE 530
Second Line :
City : LEWISVILLE
State : TX
Zip : 75077-2876
Country : US
Telephone Number : 972-420-6605
Fax Number : 972-436-2770
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2007
Last Update Date : 12/19/2018

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