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NPI Code Detail

MEDICARE: OLIVIA HAGGERTY DPT

MEDICARE:   OLIVIA  HAGGERTY  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
1225100000XPhysical Therapist1357011TX

General Provider Information

NPI Number : 1992442644
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLIVIA HAGGERTY DPT
Provider Business Mailing Address
First Line : 1002 N YALE BLVD
Second Line :
City : RICHARDSON
State : TX
Zip : 75081-3116
Country : US
Telephone Number : 972-762-2540
Fax Number :
Provider Business Practice Location Address
First Line : 8144 WALNUT HILL LN STE 100
Second Line :
City : DALLAS
State : TX
Zip : 75231-4301
Country : US
Telephone Number : 214-346-0677
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2022
Last Update Date : 05/15/2022

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Directions to “ OLIVIA HAGGERTY DPT” Practice Location

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