Provider Demographics
NPI:1376756122
Name:WARNER, HELEN K (LVN, LMT)
Entity Type:Individual
Prefix:MRS
First Name:HELEN
Middle Name:K
Last Name:WARNER
Suffix:
Gender:F
Credentials:LVN, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8700 COVE MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76123-2505
Mailing Address - Country:US
Mailing Address - Phone:817-370-8204
Mailing Address - Fax:817-370-8634
Practice Address - Street 1:5701 WESTCREEK DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76133-3301
Practice Address - Country:US
Practice Address - Phone:817-423-0021
Practice Address - Fax:817-370-8634
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT037532225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist