Provider Demographics
NPI:1285305664
Name:HANNA-BIDWELL, DARBY (PT)
Entity type:Individual
Prefix:
First Name:DARBY
Middle Name:
Last Name:HANNA-BIDWELL
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 1:615 E SCHUSTER AVE STE 9A
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-4360
Mailing Address - Country:US
Mailing Address - Phone:915-444-5200
Mailing Address - Fax:
Practice Address - Street 1:615 E SCHUSTER AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-4350
Practice Address - Country:US
Practice Address - Phone:915-444-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-24
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1353744225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist