Provider Demographics
NPI:1467685883
Name:MCFADDIN, MICHELLE D (DPT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:D
Last Name:MCFADDIN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4607 MANCHACA RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1607
Mailing Address - Country:US
Mailing Address - Phone:512-916-1511
Mailing Address - Fax:512-916-1532
Practice Address - Street 1:4607 MANCHACA RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1607
Practice Address - Country:US
Practice Address - Phone:512-916-1511
Practice Address - Fax:512-916-1532
Is Sole Proprietor?:No
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11908182251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics