Basic Information
Provider Information
NPI: 1588787733
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARFSTEN
FirstName: CASEY
MiddleName: LEE
NamePrefix: MS.
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 966 N GARDEN RIDGE BLVD
Address2: SUITE 530
City: LEWISVILLE
State: TX
PostalCode: 750772827
CountryCode: US
TelephoneNumber: 9724206605
FaxNumber: 9724362770
Practice Location
Address1: 3501 MIDWAY RD
Address2: SUITE 198
City: PLANO
State: TX
PostalCode: 750938117
CountryCode: US
TelephoneNumber: 9727812322
FaxNumber: 9727812373
Other Information
ProviderEnumerationDate: 04/10/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X1168077TXY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

ID Information
IDTypeStateIssuerDescription
116807701TXLICENSEOTHER


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