Provider Demographics
NPI:1285016030
Name:MESSINGER, SUZY (PTA)
Entity Type:Individual
Prefix:
First Name:SUZY
Middle Name:
Last Name:MESSINGER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 GRAYSON LN
Mailing Address - Street 2:
Mailing Address - City:LAKE DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75065-3483
Mailing Address - Country:US
Mailing Address - Phone:214-908-0161
Mailing Address - Fax:
Practice Address - Street 1:517 GRAYSON LN
Practice Address - Street 2:
Practice Address - City:LAKE DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75065-3483
Practice Address - Country:US
Practice Address - Phone:214-908-0161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-28
Last Update Date:2015-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10919225200000X
TX2045037225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant