Edith Head, PT
Individual provider Active NPI Physical Therapist · Edgewood, TX
NPI 1790910263 · NPPES record last updated May 27, 2009
Key facts
- NPI
- 1790910263
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1039728 (TX)
- Practice address
- 108 N Houston
Edgewood, TX 75117 - Phone
- (903) 896-1700
- NPI assigned
- May 27, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
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 |
|---|---|---|---|
| 1039728 | TX | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gober LLC | Physical Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1039728 | TX | Yes |
Addresses
Primary practice location
108 N Houston
Edgewood, TX 75117
Mailing address
PO Box 234
Edgewood, TX 75117
Other providers in Edgewood, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2009. 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.