Provider Demographics
NPI:1679954481
Name:HONEYCUTT, LAYNI (PT)
Entity Type:Individual
Prefix:
First Name:LAYNI
Middle Name:
Last Name:HONEYCUTT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LAYNI
Other - Middle Name:
Other - Last Name:ROEVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:432 SAMUELS AVE APT 8206
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76102-2517
Mailing Address - Country:US
Mailing Address - Phone:325-650-6110
Mailing Address - Fax:
Practice Address - Street 1:1000 SAINT LOUIS AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-3366
Practice Address - Country:US
Practice Address - Phone:817-921-5020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-17
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1265046225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist