Provider Demographics
NPI:1386126738
Name:FAUSS, DANIELLE (PT, DPT)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:FAUSS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1517 CHERRY BARK DR
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-2062
Mailing Address - Country:US
Mailing Address - Phone:515-724-2942
Mailing Address - Fax:
Practice Address - Street 1:1901 COOPER ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2546
Practice Address - Country:US
Practice Address - Phone:817-877-8977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-02
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0015938225100000X
TX1319753225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist