Provider Demographics
NPI:1326309402
Name:ASHFORD, BRENT DOUGLAS (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:BRENT
Middle Name:DOUGLAS
Last Name:ASHFORD
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 1:6768 W ADAMS AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-5708
Mailing Address - Country:US
Mailing Address - Phone:254-899-4280
Mailing Address - Fax:254-295-0683
Practice Address - Street 1:1007 S HIGHWAY 183
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-1989
Practice Address - Country:US
Practice Address - Phone:512-260-4900
Practice Address - Fax:512-260-4910
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-05
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3111900225100000X
TX1218361225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist