Provider Demographics
NPI:1063646180
Name:PEAK PHYSICAL THERAPY AND SPORTS MEDICINE CENTER OF FRISCO, P.L.L.C.
Entity Type:Organization
Organization Name:PEAK PHYSICAL THERAPY AND SPORTS MEDICINE CENTER OF FRISCO, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:R
Authorized Official - Last Name:ESTES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:972-377-4111
Mailing Address - Street 1:PO BOX 674172
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-4172
Mailing Address - Country:US
Mailing Address - Phone:214-369-8555
Mailing Address - Fax:214-369-2683
Practice Address - Street 1:3010 GAYLORD PKWY
Practice Address - Street 2:STE. 140
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-8664
Practice Address - Country:US
Practice Address - Phone:972-377-4111
Practice Address - Fax:972-377-4148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-04
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Multi-Specialty
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0085JBOtherBCBS
TX0085JBOtherBCBS