Provider Demographics
NPI:1245554146
Name:BRUMMETT, MINDY NICOLE (PT,DPT)
Entity type:Individual
Prefix:MRS
First Name:MINDY
Middle Name:NICOLE
Last Name:BRUMMETT
Suffix:
Gender:F
Credentials:PT,DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4401 LONG PRAIRIE RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-1794
Mailing Address - Country:US
Mailing Address - Phone:972-691-1331
Mailing Address - Fax:972-691-1731
Practice Address - Street 1:4401 LONG PRAIRIE RD
Practice Address - Street 2:SUITE 300
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1794
Practice Address - Country:US
Practice Address - Phone:972-691-1331
Practice Address - Fax:972-691-1731
Is Sole Proprietor?:No
Enumeration Date:2010-03-22
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1194581225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist