Provider Demographics
NPI:1366818197
Name:WARNKE, TRISHA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:TRISHA
Middle Name:
Last Name:WARNKE
Suffix:
Gender:F
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 1:2218 STRATTON LN APT 12202
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-5548
Mailing Address - Country:US
Mailing Address - Phone:817-966-2315
Mailing Address - Fax:
Practice Address - Street 1:2008 L DON DODSON DR
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-5788
Practice Address - Country:US
Practice Address - Phone:817-288-0121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-17
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1265252225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist