Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tan Ta

Individual provider Physical Therapist · NPI 1003678673

Tan Ta is a Physical Therapist in Private Practice in Mansfield, Texas. Qualified in 2023, 3 years ago. Registered with an NPI since 2024.

Years since qualifying
3
In the registry since
2024

Practice location Address checks out

3020 E Broad St Ste 112
Mansfield, TX 76063-6696
Phone: (682) 422-7580
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1003678673
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 29, 2024
Last updated in NPPESJanuary 29, 2024
Certification dateJanuary 29, 2024
Mailing address3020 E Broad St Ste 112, Mansfield, TX 76063-6696

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated

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