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Contact Information

DUSTIN GAULT, PTA
7307 UNIVERSITY AVE
LUBBOCK, TX79423-1422
 Phone: 806-412-4200
 Fax: 806-412-4201
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Mechanotherapist

172M00000X
Indicates primary specialty

NPI Profile & details for DUSTIN GAULT · (Male)

NPI Number 1932592789
Status Active
Credentials PTA (Physical Therapist Assistant)
Entity Individual
Enumeration date 03/17/2015
Last updated 03/17/2015 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • TX License # 2097086
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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