Provider Demographics
NPI:1073695805
Name:FIRRA, JOAN CRUMMEY (PT, PHD)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:CRUMMEY
Last Name:FIRRA
Suffix:
Gender:F
Credentials:PT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10557 NEW CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-2269
Mailing Address - Country:US
Mailing Address - Phone:214-348-3516
Mailing Address - Fax:214-348-5727
Practice Address - Street 1:10557 NEW CHURCH RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-2269
Practice Address - Country:US
Practice Address - Phone:214-348-3516
Practice Address - Fax:214-348-5727
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1001667208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX087663301Medicaid
TX087663301Medicaid