Provider Demographics
NPI:1083159941
Name:BROOKS, ABIGALE (PT)
Entity Type:Individual
Prefix:MS
First Name:ABIGALE
Middle Name:
Last Name:BROOKS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 CEDAR ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-2656
Mailing Address - Country:US
Mailing Address - Phone:469-272-3129
Mailing Address - Fax:469-272-3145
Practice Address - Street 1:216 CEDAR ST
Practice Address - Street 2:SUITE 110
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-2656
Practice Address - Country:US
Practice Address - Phone:469-272-3129
Practice Address - Fax:469-272-3145
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-03
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1242669225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist