MEDICARE: SAMANTHA RENEE HONIE 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	1307509	TX

General Provider Information

NPI Number	:	1992288260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA RENEE HONIE DPT

Provider Business Mailing Address
First Line	:	PO BOX 1566
Second Line	:
City	:	LA FERIA
State	:	TX
Zip	:	78559-1566
Country	:	US
Telephone Number	:	956-245-0527
Fax Number	:

Provider Business Practice Location Address
First Line	:	3540 VICTORY BLVD
Second Line	:
City	:	YORKTOWN
State	:	VA
Zip	:	23693-3641
Country	:	US
Telephone Number	:	757-230-2202
Fax Number	:

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

Provider Enumeration Date	:	09/12/2018
Last Update Date	:	04/19/2021

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