Coleman Kamp
Individual provider Active NPI Physical Therapist · Lavon, TX
NPI 1851753552 · NPPES record last updated Mar 22, 2016
Key facts
- NPI
- 1851753552
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1271398 (TX)
- Practice address
- 1096 Meadow Hill Dr
Lavon, TX 75166-1268 - Phone
- (972) 795-5822
- NPI assigned
- Mar 22, 2016
- Sex
- Male
- 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 |
|---|---|---|---|
| 1271398 | TX | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1271398 | TX | Yes |
Addresses
Primary practice location
1096 Meadow Hill Dr
Lavon, TX 75166-1268
Mailing address
1096 Meadow Hill Dr
Lavon, TX 75166-1268
Other providers in Lavon, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2016. 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.