Provider Demographics
NPI:1053377747
Name:WHITWORTH, LINDA L (PT OCS)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:L
Last Name:WHITWORTH
Suffix:
Gender:F
Credentials:PT OCS
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:CLAIRE
Other - Last Name:LEBLANC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1019 SUNDANCE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-4261
Mailing Address - Country:US
Mailing Address - Phone:512-894-0547
Mailing Address - Fax:
Practice Address - Street 1:4534 WESTGATE BLVD
Practice Address - Street 2:STE 104 TOWN AND COUNTRY PT
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745
Practice Address - Country:US
Practice Address - Phone:512-892-7337
Practice Address - Fax:512-892-7339
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1013886225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist