Basic Information
| Provider Information | |||||||||
| NPI: | 1639520380 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DRAGG | ||||||||
| FirstName: | HEATHER | ||||||||
| MiddleName: | DANIELLE | ||||||||
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| Credential: | PT, DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3301 SUNDOWN BLVD | ||||||||
| Address2: | |||||||||
| City: | DENTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 762108032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9403873700 | ||||||||
| FaxNumber: | 9404884513 | ||||||||
| Practice Location | |||||||||
| Address1: | 212 BOLIVAR ST STE 100 | ||||||||
| Address2: | |||||||||
| City: | SANGER | ||||||||
| State: | TX | ||||||||
| PostalCode: | 762669775 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9403877601 | ||||||||
| FaxNumber: | 9402576200 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2016 | ||||||||
| LastUpdateDate: | 03/24/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 5193 | OK | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 1324782 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.