Provider Demographics
NPI:1275242273
Name:OVERFIELD, DANE MICHAEL (LPT)
Entity Type:Individual
Prefix:
First Name:DANE
Middle Name:MICHAEL
Last Name:OVERFIELD
Suffix:
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 E NOLANA AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-6101
Mailing Address - Country:US
Mailing Address - Phone:956-686-6510
Mailing Address - Fax:
Practice Address - Street 1:1005 E NOLANA AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-6101
Practice Address - Country:US
Practice Address - Phone:956-686-6510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1370402225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist