Provider Demographics
NPI:1073540019
Name:PEAK PHYSICAL THERAPY AND SPORTS MEDICINE CENTERS AT CRAIG RANCH, PLLC
Entity Type:Organization
Organization Name:PEAK PHYSICAL THERAPY AND SPORTS MEDICINE CENTERS AT CRAIG RANCH, PLLC
Other - Org Name:CORE SPECIALIZED PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:K
Authorized Official - Last Name:HALL ASHBY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:972-359-8502
Mailing Address - Street 1:8080 STATE HIGHWAY 121
Mailing Address - Street 2:SUITE 310
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070
Mailing Address - Country:US
Mailing Address - Phone:972-359-8502
Mailing Address - Fax:972-359-1749
Practice Address - Street 1:8080 STATE HIGHWAY 121
Practice Address - Street 2:SUITE 310
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070
Practice Address - Country:US
Practice Address - Phone:972-359-8502
Practice Address - Fax:972-359-1749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty