Provider Demographics
NPI:1720615941
Name:NECKER, DANIELLE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:NECKER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 HEDGEBROOK WAY
Mailing Address - Street 2:
Mailing Address - City:THE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78738-1319
Mailing Address - Country:US
Mailing Address - Phone:512-970-9544
Mailing Address - Fax:
Practice Address - Street 1:302 MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78738-5632
Practice Address - Country:US
Practice Address - Phone:512-501-3488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1321559225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist