Provider Demographics
NPI:1083069801
Name:PMST MANAGEMENT GROUP
Entity Type:Organization
Organization Name:PMST MANAGEMENT GROUP
Other - Org Name:PERFORMANCE CHIROPRACTIC & SPORTS MEDICINE PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:
Authorized Official - Last Name:GOVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-473-8980
Mailing Address - Street 1:6001 WINDHAVEN PKWY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8017
Mailing Address - Country:US
Mailing Address - Phone:972-473-8980
Mailing Address - Fax:972-212-6851
Practice Address - Street 1:6101 WINDHAVEN PKWY STE 145
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8198
Practice Address - Country:US
Practice Address - Phone:972-473-8980
Practice Address - Fax:972-212-6851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-29
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty