Provider Demographics
NPI:1518155936
Name:VASAY, HAZEL LYN GARCIA (PT)
Entity Type:Individual
Prefix:MISS
First Name:HAZEL LYN
Middle Name:GARCIA
Last Name:VASAY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2326 MAINSAIL LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-4001
Mailing Address - Country:US
Mailing Address - Phone:817-233-2153
Mailing Address - Fax:817-472-6456
Practice Address - Street 1:3301 VIEW ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76103-2425
Practice Address - Country:US
Practice Address - Phone:817-531-3616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-10
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1169633225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist