Provider Demographics
NPI:1114935988
Name:MCGINTY, TRENT L (PT)
Entity Type:Individual
Prefix:
First Name:TRENT
Middle Name:L
Last Name:MCGINTY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3724 EXECUTIVE CENTER DR
Mailing Address - Street 2:SUITE G-10
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-1646
Mailing Address - Country:US
Mailing Address - Phone:512-345-5925
Mailing Address - Fax:
Practice Address - Street 1:3724 EXECUTIVE CENTER DR
Practice Address - Street 2:SUITE G-10
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-1646
Practice Address - Country:US
Practice Address - Phone:512-345-5925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1145423225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX301322901Medicaid
TX301322901Medicaid