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NPI Code Detail

MEDICARE: ANNE L KING PTA

MEDICARE: ANNE L KING PTA
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
1225200000XPhysical Therapy Assistant2056750TX

General Provider Information

NPI Number : 1972707867
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNE L KING PTA
Provider Business Mailing Address
First Line : 1513 BIRCHBROOK DR
Second Line :
City : FLOWERMOUND
State : TX
Zip : 75028-4307
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 901 PENNSYLVANIA AVE
Second Line :
City : FT WORTH
State : TX
Zip : 76104-2226
Country : US
Telephone Number : 817-348-9711
Fax Number : 817-348-9809
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2007
Last Update Date : 07/08/2007

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Directions to “ ANNE L KING PTA” Practice Location

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