Provider Demographics
NPI:1780696377
Name:CULVER, DANINA LEE (PT)
Entity type:Individual
Prefix:
First Name:DANINA
Middle Name:LEE
Last Name:CULVER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4310 RAMSEY AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756
Mailing Address - Country:US
Mailing Address - Phone:512-784-5485
Mailing Address - Fax:512-453-6995
Practice Address - Street 1:4310 RAMSEY AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756
Practice Address - Country:US
Practice Address - Phone:512-784-5485
Practice Address - Fax:512-453-6995
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10232732251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX062701001Medicaid
TX659061OtherBCBS PROVIDER NUMBER