Provider Demographics
NPI:1245742022
Name:MCELFRESH, BRENT (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:BRENT
Middle Name:
Last Name:MCELFRESH
Suffix:
Gender:M
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 1:3718 ENCHANTED ROCK RD
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-4184
Mailing Address - Country:US
Mailing Address - Phone:254-592-2431
Mailing Address - Fax:
Practice Address - Street 1:1602 S CLACK ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-4610
Practice Address - Country:US
Practice Address - Phone:325-691-0093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-01
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1248045225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist