Provider Demographics
NPI:1730747619
Name:CARPENTER, TRENTON RILEY (PT, DPT)
Entity type:Individual
Prefix:
First Name:TRENTON
Middle Name:RILEY
Last Name:CARPENTER
Suffix:
Gender:M
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 1:9660 BARTLETT CIR STE 708
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76108-4465
Mailing Address - Country:US
Mailing Address - Phone:817-862-9667
Mailing Address - Fax:903-753-1114
Practice Address - Street 1:9660 BARTLETT CIR STE 708
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76108-4465
Practice Address - Country:US
Practice Address - Phone:817-862-9667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14480045225100000X
TX1318797225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist