Lacie Daniel, PTA
Individual provider Active NPI Physical Therapy Assistant · Azle, TX
NPI 1740744937 · NPPES record last updated Jan 22, 2019
Key facts
- NPI
- 1740744937
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 2136356 (TX)
- Practice address
- 721 Dunaway LN
Azle, TX 76020-2605 - Phone
- (817) 444-2536
- NPI assigned
- Jan 22, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2136356 | TX | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2136356 | TX | Yes |
Addresses
Primary practice location
721 Dunaway LN
Azle, TX 76020-2605
Mailing address
8612 Guadalupe Rd
Fort Worth, TX 76116-6702
Phone (682) 556-9556
Other providers in Azle, TX
- Cody Cribbs
- CSL Azle 2016, LLC
- CVS Pharmacy Inc
- Carla C Dahms
- Tran Bao Dang
- Sally Daniels
- David Lindley, DO, PA
- Ila Lindsey Davie
- Amanda Diffie
- Meggan Dimerling
All providers in Azle, TX · Physical Therapy Assistant in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.