Provider Demographics
NPI:1225797418
Name:RECKE, HALEY CAROL (PT, DPT)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:CAROL
Last Name:RECKE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 ROGERS RD APT 624
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-6591
Mailing Address - Country:US
Mailing Address - Phone:603-759-8713
Mailing Address - Fax:
Practice Address - Street 1:2001 N MACARTHUR BLVD STE 550
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-2255
Practice Address - Country:US
Practice Address - Phone:972-990-8155
Practice Address - Fax:971-990-4398
Is Sole Proprietor?:No
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1355391225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist