Provider Demographics
NPI:1730911058
Name:ANDERSON, CAMEIA BRIANNE (PT, DPT)
Entity type:Individual
Prefix:
First Name:CAMEIA
Middle Name:BRIANNE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 EXECUTIVE DR APT 5208
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-0262
Mailing Address - Country:US
Mailing Address - Phone:501-655-2473
Mailing Address - Fax:
Practice Address - Street 1:4825 ALLIANCE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5578
Practice Address - Country:US
Practice Address - Phone:469-606-1378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1396143225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist