Provider Demographics
NPI:1235470816
Name:SOUZA, DARCY MARIE (LPT)
Entity Type:Individual
Prefix:MS
First Name:DARCY
Middle Name:MARIE
Last Name:SOUZA
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:MS
Other - First Name:DARCY
Other - Middle Name:MARIE
Other - Last Name:HOSTETLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10182 E GRAY HAWK DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85730-6113
Mailing Address - Country:US
Mailing Address - Phone:520-730-0099
Mailing Address - Fax:
Practice Address - Street 1:5001 STATESMAN DRIVE
Practice Address - Street 2:MED TRAVELERS
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063
Practice Address - Country:US
Practice Address - Phone:800-788-4815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2546225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist