Provider Demographics
NPI:1972246528
Name:BELL, LYNAE Y (PTA)
Entity Type:Individual
Prefix:
First Name:LYNAE
Middle Name:Y
Last Name:BELL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4204 STONEBRIAR TRL
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-5875
Mailing Address - Country:US
Mailing Address - Phone:817-592-3021
Mailing Address - Fax:888-557-1669
Practice Address - Street 1:2363 HIGHWAY 287 N STE 205
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-7587
Practice Address - Country:US
Practice Address - Phone:817-592-3021
Practice Address - Fax:888-557-1669
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2153318225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty