Provider Demographics
NPI:1992896831
Name:COLLINS, WENDY WALKER (PT, MPT, OCS)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:WALKER
Last Name:COLLINS
Suffix:
Gender:F
Credentials:PT, MPT, OCS
Other - Prefix:MS
Other - First Name:WENDY
Other - Middle Name:MARIE
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, MPT, OCS
Mailing Address - Street 1:411 N WASHINGTON AVE
Mailing Address - Street 2:STE 4000
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1713
Mailing Address - Country:US
Mailing Address - Phone:214-820-7457
Mailing Address - Fax:214-820-1654
Practice Address - Street 1:411 N WASHINGTON AVE
Practice Address - Street 2:STE 4000
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1713
Practice Address - Country:US
Practice Address - Phone:214-820-7457
Practice Address - Fax:214-820-1654
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA049682251X0800X
TX11869472251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic