Timothy O'dell Puckett, DPT is a
Physical Therapist - Orthopedic based in Leon Valley, Texas. Timothy O'dell Puckett is licensed to practice in Texas (license number 1206227) and his current practice location is
7007 Bandera Rd Ste 3, Leon Valley, Texas. He can be reached at his office (for appointments etc.) via phone at
(210) 387-6993.
NPI number for Timothy O'dell Puckett is 1184910507 and his current mailing address is 12047 Stoney Xing, San Antonio, Texas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1184910507.
Healthcare Provider's Profile
| Full Name | Timothy O'dell Puckett |
|---|
| Gender | Male |
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| Speciality | Physical Therapist - Orthopedic |
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| Location | 7007 Bandera Rd Ste 3, Leon Valley, Texas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1184910507
- Provider Enumeration Date: 06/23/2011
- Last Update Date: 05/04/2018
Medical Identifiers
Medical identifiers for Timothy O'dell Puckett such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1184910507 | NPI | - | NPPES |
| 290438501 | Medicaid | TX | |
| 12284562 | Other | TX | CAQH |
| 867T19 | Other | TX | BCBSTX |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 225100000X | Physical Therapist | 1206227 (Texas) | Secondary |
| 2251S0007X | Physical Therapist - Sports | 1206227 (Texas) | Secondary |
| 2251X0800X | Physical Therapist - Orthopedic | 1206227 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Timothy O'dell Puckett is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Timothy O'dell Puckett, DPT
12047 Stoney Xing,
San Antonio, TX 78247-3453
Ph: (210) 387-6993 | Timothy O'dell Puckett, DPT
7007 Bandera Rd Ste 3,
Leon Valley, TX 78238-1264
Ph: (210) 387-6993 |
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