Provider Demographics
NPI:1528189024
Name:FINCHER, VIRGINIA KATHLEEN (PT)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:KATHLEEN
Last Name:FINCHER
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 1:1524 MIMS ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76112-3456
Mailing Address - Country:US
Mailing Address - Phone:817-614-1699
Mailing Address - Fax:866-574-1033
Practice Address - Street 1:2300 GRAVEL DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76118-6950
Practice Address - Country:US
Practice Address - Phone:817-589-7033
Practice Address - Fax:817-595-1178
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1014991225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0626715-01Medicaid
TX658061OtherBCBS
TX85063TOtherBCBS