Provider Demographics
NPI:1316350283
Name:SIZEMORE, CHARLES (DPT)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:
Last Name:SIZEMORE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 N BELT LINE RD
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-1781
Mailing Address - Country:US
Mailing Address - Phone:972-288-2400
Mailing Address - Fax:972-288-0222
Practice Address - Street 1:1010 N BELT LINE RD
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-1781
Practice Address - Country:US
Practice Address - Phone:972-288-2400
Practice Address - Fax:972-288-0222
Is Sole Proprietor?:No
Enumeration Date:2014-06-08
Last Update Date:2014-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1243323225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist