Provider Demographics
NPI:1245479542
Name:ROEHR, TAMI LYNN (PT)
Entity type:Individual
Prefix:
First Name:TAMI
Middle Name:LYNN
Last Name:ROEHR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5536 E LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-4813
Mailing Address - Country:US
Mailing Address - Phone:254-702-3995
Mailing Address - Fax:
Practice Address - Street 1:3411 MARKET LOOP STE 102
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-2771
Practice Address - Country:US
Practice Address - Phone:254-598-2078
Practice Address - Fax:254-598-2076
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-10
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1115780225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist