Provider Demographics
NPI:1992493803
Name:FLEMING, BROOKE (DPT)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:FLEMING
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3355 BLACKBURN ST APT 9101
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-1551
Mailing Address - Country:US
Mailing Address - Phone:972-655-4246
Mailing Address - Fax:
Practice Address - Street 1:8050 MEADOW RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3406
Practice Address - Country:US
Practice Address - Phone:469-232-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1374634225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty