Provider Demographics
NPI:1841407376
Name:HABECKER, VICKI (PT)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:
Last Name:HABECKER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3517 DARTMOUTH DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-7825
Mailing Address - Country:US
Mailing Address - Phone:972-964-6589
Mailing Address - Fax:
Practice Address - Street 1:1200 COIT RD
Practice Address - Street 2:SUITE 101A
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-4750
Practice Address - Country:US
Practice Address - Phone:972-964-6589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1007938225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist