Provider Demographics
NPI:1730668591
Name:BLESSING, WILLIAM (PTA)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:BLESSING
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9201 GARLAND RD APT 225
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-3707
Mailing Address - Country:US
Mailing Address - Phone:740-802-4376
Mailing Address - Fax:
Practice Address - Street 1:500 W 3RD AVE STE 6
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-4564
Practice Address - Country:US
Practice Address - Phone:903-872-5925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-11
Last Update Date:2018-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2086069225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant