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Organization
TARRANT SPORTS & PHYSICAL THERAPY
Active
Organization
TARRANT SPORTS & PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS HEATHER A RUSSELL PT (PHYSICAL THERAPIST OWNER)
(817) 741-8122
Entity
Organization
Contact information
Practice address
801 S MAIN ST, SUITE 117, KELLER, TX 76248-7026
(817) 741-8122
Mailing address
801 S MAIN ST, SUITE 117, KELLER, TX 76248-7026
(817) 741-8122
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1110955
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1922199116
NPI INDIVIDUAL
NY
01
—
8T6880
BLUE CROSS BLUE SHIELD
TX
Enumeration date
05/23/2007
Last updated
08/22/2020
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