Provider Demographics
NPI:1093213845
Name:BIRLIN, JOHN DALTON (PT, DPT, ATC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DALTON
Last Name:BIRLIN
Suffix:
Gender:M
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 W PLANO PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8201
Mailing Address - Country:US
Mailing Address - Phone:469-750-9971
Mailing Address - Fax:214-291-2648
Practice Address - Street 1:6101 W PLANO PKWY STE 100
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8201
Practice Address - Country:US
Practice Address - Phone:469-750-9971
Practice Address - Fax:214-291-2648
Is Sole Proprietor?:No
Enumeration Date:2018-01-26
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2251P0200X
TX1301851225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics