Most Relevant Information
Provider Data
| NPI Number: | 1003572389 |
| Provider Name: | AZURE BERRY PTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | PTA2154612 |
Most Important Dates
| Enumeration Date: | 11/11/2021 |
| Last Updated: | 11/11/2021 |
Provider Practice Location
800 W RANDOL MILL RD FL 6
ARLINGTON
TX
760122504
Practice Location Phone/Fax
| Phone: | 8176018000 |
| Fax: | 3523821146 |
Provider Mailing Location
8477 S SUNCOAST BLVD
HOMOSASSA
FL
344465028
Provider Mailing Phone/Fax
| Phone: | 8008049961 |
| Fax: | 3523821146 |