Wisdom, Tara Leigh
Wisdom, Tara Leigh is an individual health care provider with primary practice located at 3800 Hulen St , Fort Worth TX 76107-7276. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Wisdom, Tara Leigh can be contacted via phone (512) 876-8595.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 1156069 | Texas |
Profile Details
| NPI number | 1740259308 |
|---|---|
| LBN Legal business name | Wisdom, Tara Leigh |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 16th, 2006 |
| Last updated | Feb 2nd, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740259308 | NPPES |
| Texas | Other | 8FAV58 | BLUE CROSS BLUE SHIELD |
| Texas | MEDICAID | 348440401 | BLUE CROSS BLUE SHIELD |
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