Provider Demographics
NPI:1013284819
Name:ABBOTT, JANICE (PT, MS, CHT)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:PT, MS, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8144 WALNUT HILL LN
Mailing Address - Street 2:STE 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4388
Mailing Address - Country:US
Mailing Address - Phone:214-346-0677
Mailing Address - Fax:
Practice Address - Street 1:8144 WALNUT HILL LN
Practice Address - Street 2:STE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4388
Practice Address - Country:US
Practice Address - Phone:214-346-0677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-21
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11001052251H1200X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX895T12OtherBCBS
TX896T14OtherBCBS
TX896T14OtherBCBS
TX282312YRGMedicare PIN
TX895T12OtherBCBS