Provider Demographics
NPI:1750375754
Name:POYNOR, DOLORES JANET (PT)
Entity type:Individual
Prefix:MRS
First Name:DOLORES
Middle Name:JANET
Last Name:POYNOR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DOLORES
Other - Middle Name:JANET
Other - Last Name:REED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3233 S WILLIS ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-6649
Mailing Address - Country:US
Mailing Address - Phone:325-692-4500
Mailing Address - Fax:325-692-4585
Practice Address - Street 1:3233 S WILLIS ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-6649
Practice Address - Country:US
Practice Address - Phone:325-692-4500
Practice Address - Fax:325-692-4585
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1011641225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T1448OtherBLUE CROSS
TXA006OtherTRICARE
TXA006OtherTRICARE