Provider Demographics
NPI:1639659501
Name:BOUNDS, TAMERA (LPTA)
Entity Type:Individual
Prefix:
First Name:TAMERA
Middle Name:
Last Name:BOUNDS
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 MERIWETHER ST
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-6039
Mailing Address - Country:US
Mailing Address - Phone:817-627-7288
Mailing Address - Fax:
Practice Address - Street 1:1009 MERIWETHER ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-6039
Practice Address - Country:US
Practice Address - Phone:817-627-7288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2023729225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant