Provider Demographics
NPI:1053969832
Name:NOLTING, DANIEL PATRICK
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:PATRICK
Last Name:NOLTING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8503 TIP TOP DR
Mailing Address - Street 2:
Mailing Address - City:JONESTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78645-9624
Mailing Address - Country:US
Mailing Address - Phone:817-875-5433
Mailing Address - Fax:
Practice Address - Street 1:8503 TIP TOP DR
Practice Address - Street 2:
Practice Address - City:JONESTOWN
Practice Address - State:TX
Practice Address - Zip Code:78645-9624
Practice Address - Country:US
Practice Address - Phone:817-875-5433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2044964225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant