Individual
DESRA AILEEN WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
5601 BRIDGE ST, FORT WORTH, TX 76112-2384
(817) 446-5000
Mailing address
12908 GLENVILLE CT, FORT WORTH, TX 76244-5779
(682) 597-1930
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2043164
TX
Other
Enumeration date
09/23/2009
Last updated
09/23/2009
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