Provider Demographics
NPI:1467212308
Name:COLEMAN, AUDREY LEIGH (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:AUDREY
Middle Name:LEIGH
Last Name:COLEMAN
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 1:11317 CHERISSE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78739-1995
Mailing Address - Country:US
Mailing Address - Phone:214-435-2510
Mailing Address - Fax:
Practice Address - Street 1:5200 DAVIS LN BLDG A
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-4071
Practice Address - Country:US
Practice Address - Phone:512-301-8747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13457262251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics