Elizabeth Marie Bourg, DPT
Physical Therapist in Southlake, TX. Individual provider (NPI-1).
NPI number1265366199
StatusActive
Last updated in NPPESJun 8, 2026
Details
- NPI
- 1265366199
- Entity type
- Individual (NPI-1)
- Name
- Elizabeth Marie Bourg
- Credential
- DPT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 8, 2026
- Certification date
- Jun 8, 2026
- Last updated
- Jun 8, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 12012 | LA | Yes |
| 225100000X | Physical Therapist | CP057805T | TX |
Practice location
180 State St Ste 225Southlake, TX 76092-7632
Phone 866-525-3175
Mailing address
180 State St Ste 225Southlake, TX 76092-7632
Phone 866-525-3175
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All 128 Physical Therapist providers in Southlake · All 2,154 providers in Southlake
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