Provider Demographics
NPI:1386080398
Name:JAVIER, DENNIS ERWIN (PT)
Entity type:Individual
Prefix:
First Name:DENNIS ERWIN
Middle Name:
Last Name:JAVIER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1604 PARK GARDEN CT
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-7816
Mailing Address - Country:US
Mailing Address - Phone:817-371-9150
Mailing Address - Fax:972-299-5917
Practice Address - Street 1:1604 PARK GARDEN CT
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-7816
Practice Address - Country:US
Practice Address - Phone:817-371-9150
Practice Address - Fax:972-299-5917
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-16
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1065274225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist