Provider Demographics
NPI:1376023002
Name:PARRACK, JANIS J (LPTA)
Entity Type:Individual
Prefix:
First Name:JANIS
Middle Name:J
Last Name:PARRACK
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2503 VINCENT ST
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76801-4937
Mailing Address - Country:US
Mailing Address - Phone:254-592-4005
Mailing Address - Fax:
Practice Address - Street 1:2503 VINCENT ST
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-4937
Practice Address - Country:US
Practice Address - Phone:254-592-4005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2032001225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant