Provider Demographics
NPI:1811562143
Name:CHANEY, AUBRIEN ALIA (DPT)
Entity Type:Individual
Prefix:
First Name:AUBRIEN
Middle Name:ALIA
Last Name:CHANEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4002 PRESCOTT AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-2243
Mailing Address - Country:US
Mailing Address - Phone:214-517-4717
Mailing Address - Fax:
Practice Address - Street 1:11617 N CENTRAL EXPY STE 140
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3845
Practice Address - Country:US
Practice Address - Phone:214-369-4123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3126321225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist