Provider Demographics
NPI:1023179280
Name:HUNTER, TIFFANEY (PT, DPT, CLT)
Entity Type:Individual
Prefix:DR
First Name:TIFFANEY
Middle Name:
Last Name:HUNTER
Suffix:
Gender:F
Credentials:PT, DPT, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3851 SW GREEN OAKS BLVD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017
Mailing Address - Country:US
Mailing Address - Phone:817-476-6332
Mailing Address - Fax:817-476-6333
Practice Address - Street 1:3851 SW GREEN OAKS BLVD
Practice Address - Street 2:SUITE 109
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017
Practice Address - Country:US
Practice Address - Phone:817-476-6332
Practice Address - Fax:817-476-6333
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX225100000X
TX1144996225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1993396 02Medicaid
TX1993396 01Medicaid