Basic Information
Provider Information
NPI: 1710088125
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WINWARD
FirstName: TROY
MiddleName: BRANT
NamePrefix: MR.
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherMiddleName:  
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Mailing Information
Address1: 800 CRESCENT CENTRE DR
Address2: SUITE 600
City: FRANKLIN
State: TN
PostalCode: 370677269
CountryCode: US
TelephoneNumber: 6153731350
FaxNumber: 6152219054
Practice Location
Address1: 1335 E WHITESTONE BLVD
Address2: SUITE O-100
City: CEDAR PARK
State: TX
PostalCode: 786137598
CountryCode: US
TelephoneNumber: 5125390032
FaxNumber: 5125390034
Other Information
ProviderEnumerationDate: 09/26/2006
LastUpdateDate: 01/22/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X1148947TXY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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