Provider Demographics
NPI:1053711564
Name:WALAKOVITS, KERI GLOVER (MS, PT)
Entity type:Individual
Prefix:
First Name:KERI
Middle Name:GLOVER
Last Name:WALAKOVITS
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Gender:F
Credentials:MS, PT
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9330 POPPY DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-4621
Mailing Address - Country:US
Mailing Address - Phone:214-324-6000
Mailing Address - Fax:214-324-6294
Practice Address - Street 1:9330 POPPY DR
Practice Address - Street 2:SUITE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-4621
Practice Address - Country:US
Practice Address - Phone:214-324-6000
Practice Address - Fax:214-324-6294
Is Sole Proprietor?:No
Enumeration Date:2014-09-03
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1-10164-0225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist