Individual
ELIZABETH J MEZZACAPPA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1005 MIDWESTERN PKWY, WICHITA FALLS, TX 76302-2211
(940) 322-0771
Mailing address
1005 MIDWESTERN PKWY, WICHITA FALLS, TX 76302-2211
(940) 322-0771
(940) 767-3715
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1273020
TX
225100000X
Physical Therapist
4462
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000Q0406
—
NM
01
—
DC4165
RR MEDICARE
NM
Enumeration date
06/10/2014
Last updated
03/17/2018
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