Provider Demographics
NPI:1447273297
Name:WALKER, CAROLYN H (PT MS)
Entity type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:H
Last Name:WALKER
Suffix:
Gender:F
Credentials:PT MS
Other - Prefix:MISS
Other - First Name:CAROLYN
Other - Middle Name:JO
Other - Last Name:HENDRIX
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT MS
Mailing Address - Street 1:PO BOX 847556
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-7556
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2401 S 31ST ST
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76508-0001
Practice Address - Country:US
Practice Address - Phone:254-724-2111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1057974225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist