Provider Demographics
NPI:1114292844
Name:TOP PEDIATRIC THERAPY, PC.
Entity Type:Organization
Organization Name:TOP PEDIATRIC THERAPY, PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLEY (BETSY)
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MOT/L
Authorized Official - Phone:214-618-9341
Mailing Address - Street 1:3550 PARKWOOD BLVD
Mailing Address - Street 2:STE. 704
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-1903
Mailing Address - Country:US
Mailing Address - Phone:214-618-9341
Mailing Address - Fax:214-618-9342
Practice Address - Street 1:3550 PARKWOOD BLVD
Practice Address - Street 2:STE. 704
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-1903
Practice Address - Country:US
Practice Address - Phone:214-618-9341
Practice Address - Fax:214-618-9342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center