Provider Demographics
NPI:1679753594
Name:SCHUCK, KAREN GORDY (LPT)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:GORDY
Last Name:SCHUCK
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2515 SCRIPTURE ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-2300
Mailing Address - Country:US
Mailing Address - Phone:940-566-1513
Mailing Address - Fax:940-566-7039
Practice Address - Street 1:2515 SCRIPTURE ST
Practice Address - Street 2:SUITE 204
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-2300
Practice Address - Country:US
Practice Address - Phone:940-566-1513
Practice Address - Fax:940-566-7039
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1010973225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX650137Medicare PIN