Provider Demographics
NPI:1649643008
Name:SAMPATH, DEBBIE LYNN (PT)
Entity type:Individual
Prefix:
First Name:DEBBIE
Middle Name:LYNN
Last Name:SAMPATH
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 1:2004 FOX MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-5479
Mailing Address - Country:US
Mailing Address - Phone:817-845-9177
Mailing Address - Fax:
Practice Address - Street 1:7999 W VIRGINIA DR STE E
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-3845
Practice Address - Country:US
Practice Address - Phone:972-675-7407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-06
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11071752251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic