Provider Demographics
NPI:1396404976
Name:BAILEY, DANIELLE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:BAILEY
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 1:872 WHITEHALL DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-6822
Mailing Address - Country:US
Mailing Address - Phone:972-965-8510
Mailing Address - Fax:
Practice Address - Street 1:966 N GARDEN RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75077-2827
Practice Address - Country:US
Practice Address - Phone:972-420-6605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-11
Last Update Date:2021-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1320957225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty