Provider Demographics
NPI:1720352107
Name:HOFER, DIANE ZARWELL (PT)
Entity type:Individual
Prefix:MS
First Name:DIANE
Middle Name:ZARWELL
Last Name:HOFER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:DIANE
Other - Middle Name:LOUISE
Other - Last Name:ZARWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1920 FAIR OAKS LN
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-9392
Mailing Address - Country:US
Mailing Address - Phone:972-347-9429
Mailing Address - Fax:
Practice Address - Street 1:1920 FAIR OAKS LN
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-9392
Practice Address - Country:US
Practice Address - Phone:972-347-9429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-01
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0564225100000X
TX1088037225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist