Provider Demographics
NPI:1821898784
Name:JUDSON, TRISTA M (PTA)
Entity type:Individual
Prefix:MRS
First Name:TRISTA
Middle Name:M
Last Name:JUDSON
Suffix:
Gender:
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1924 TEMPLE HLS
Mailing Address - Street 2:
Mailing Address - City:VAN ALSTYNE
Mailing Address - State:TX
Mailing Address - Zip Code:75495-8158
Mailing Address - Country:US
Mailing Address - Phone:585-472-1212
Mailing Address - Fax:
Practice Address - Street 1:3751 S STONEBRIDGE DR STE 600
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-8794
Practice Address - Country:US
Practice Address - Phone:585-472-1212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2126230225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant