Provider Demographics
NPI:1457792525
Name:BYERS, BILLIE (PTA)
Entity Type:Individual
Prefix:
First Name:BILLIE
Middle Name:
Last Name:BYERS
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 1:2829 BLUE SPRINGS PL
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-8746
Mailing Address - Country:US
Mailing Address - Phone:813-991-7366
Mailing Address - Fax:888-688-6811
Practice Address - Street 1:1105 E FITZGERALD ST
Practice Address - Street 2:
Practice Address - City:BANGS
Practice Address - State:TX
Practice Address - Zip Code:76823-3232
Practice Address - Country:US
Practice Address - Phone:325-752-6719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2070008225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant