Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 225100000X | Physical Therapist | | 1341405 | TEXAS | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 12466 | OTHER | MINNESOTA | PHYSICAL THERAPY LICENSE |
| 2 | CP004296T | OTHER | IOWA | PHYSICAL THERAPY COMPACT PRIVILEGES |
| 3 | CP004298T | OTHER | OKLAHOMA | PHYSICAL THERAPY COMPACT PRIVILEGES |
| 4 | CP004299T | OTHER | UTAH | PHYSICAL THERAPY COMPACT PRIVILEGES |
| 5 | CP004434T | OTHER | WASHINGTON | PHYSICAL THERAPY COMPACT PRIVILEGES |
| 6 | CP004598T | OTHER | ARKANSAS | PHYSICAL THERAPY COMPACT PRIVILEDGES |
| 7 | CP004610T | OTHER | GEORGIA | PHYSICAL THERAPY COMPACT PRIVILEGES |
| 8 | CP005159T | OTHER | ARIZONA | PHYSICAL THERAPY COMPACT PRIVILEDGES |
| 9 | CP008512T | OTHER | OHIO | PHYSICAL THERAPY COMPACT PRIVILEGES |
| 10 | PT200001264 | OTHER | DISTRICT OF COLUMBIA | PHYSICAL THERAPY LICENSE |
| 11 | PTP-PT-LIC-19771 | OTHER | MONTANA | PHYSICAL THERAPY LICENSE |
| 12 | 040.0134439 | OTHER | VERMONT | PHYSICAL THERAPY LICENSE |
| 13 | 172053 | OTHER | ALASKA | PHYSICAL THERAPY LICENSE |
| 14 | CP004297T | OTHER | NEBRASKA | PHYSICAL THERAPY COMPACT PRIVILEGES |
| 15 | 5501021608 | OTHER | MICHIGAN | PHYSICAL THERAPY LICENSE |
| 16 | CP004382T | OTHER | NORTH CAROLINA | PHYSICAL THERAPY COMPACT PRIVILEGES |
| 17 | CP015887T | OTHER | SOUTH DAKOTA | PHYSICAL THERAPY COMPACT PRIVILEGES |
| 18 | PT-2125 | OTHER | WYOMING | PHYSICAL THERAPY LICENSE |
| 19 | PT-5508-0 | OTHER | HAWAII | PHYSICAL THERAPY LICENSE |
| 20 | PT6048 | OTHER | NEW MEXICO | PHYSICAL THERAPY LICENSE |
| 21 | TH0000152 | OTHER | INDIANA | PHYSICAL THERAPY LICENSE |
| 22 | CP004436T | OTHER | OREGON | PHYSICAL THERAPY COMPACT PRIVILEGES |
| 23 | CP004493T | OTHER | TENNESSEE | PHYSICAL THERAPY COMPACT PRIVILEGES |
| 24 | PT03441 | OTHER | RHODE ISLAND | PHYSICAL THERAPY LICENSE |
| 25 | PT6168 | OTHER | MAINE | PHYSICAL THERAPY LICENSE |
| 26 | 05014206A | OTHER | INDIANA | PHYSICAL THERAPY LICENSE |
| 27 | 24473 | OTHER | MASSACHUSETTS | PHYSICAL THERAPY LICENSE |
| 28 | 300628 | OTHER | CALIFORNIA | PHYSICAL THERAPY LICENSE |
| 29 | 40QA02077700 | OTHER | NEW JERSEY | PHYSICAL THERAPY LICENSE |
| 30 | CP004301T | OTHER | WEST VIRGINIA | PHYSICAL THERAPY COMPACT PRIVILEGES |
| 31 | CP010973T | OTHER | MARYLAND | PHYSICAL THERAPY COMPACT PRIVILEGES |
| 32 | PTH10317 | OTHER | ALABAMA | PHYSICAL THERAPY LICENSE |
| 33 | 10780 | OTHER | SOUTH CAROLINA | PHYSICAL THERAPY LICENSE |
| 34 | 1341405 | OTHER | TEXAS | PHYSICAL THERPAY LICENSE |
| 35 | CP004599T | OTHER | MISSOURI | PHYSICAL THERAPY COMPACT PRIVILEGES |
| 36 | PT-7534 | OTHER | IDAHO | PHYSICAL THERAPY LICENSE |
| 37 | 13226 | OTHER | CONNECTICUT | PHYSICAL THERAPY LICENSE |
| 38 | 4799 | OTHER | NEVADA | PHYSICAL THERAPY LICENSE |
| 39 | CP004295T | OTHER | COLORADO | PHYSICAL THERAPY COMPACT PRIVILEGES |
| 40 | CP004300T | OTHER | VIRGINIA | PHYSICAL THERAPY COMPACT PRIVILEGES |
| 41 | CP004432T | OTHER | NORTH DAKOTA | PHYSICAL THERAPY COMPACT PRIVILEGES |
| 42 | CP004438T | OTHER | KENTUCKY | PHYSICAL THERAPY COMPACT LICENSE |
| 43 | 29062 | OTHER | MARYLAND | PHYSICAL THERAPY LICENSE |
| 44 | CP004433T | OTHER | NEW HAMPSHIRE | PHYSICAL THERAPY COMPACT PRIVILEGES |
| 45 | CP004437T | OTHER | LOUISIANA | PHYSICAL THERAPY COMPACT PRIVILEGES |
| 46 | CP017059T | OTHER | WISCONSIN | PHYSICAL THERAPY COMPACT PRIVILEGES |
| 47 | 047332-01 | OTHER | NEW YORK | PHYSICAL THERAPY LICENSE |
| 48 | 13770 | OTHER | TENNESSEE | PHYSICAL THERAPY LICENSE |
| 49 | CP004435T | OTHER | MISSISSIPPI | PHYSICAL THERAPY COMPACT PRIVILEGES |
| 50 | CP008419T | OTHER | DELAWARE | PHYSICAL THERAPY COMPACT PRIVILEGES |
