Provider Demographics
NPI:1275625923
Name:DYL, JANUSZ (LPT)
Entity Type:Individual
Prefix:
First Name:JANUSZ
Middle Name:
Last Name:DYL
Suffix:
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 OSLER DR
Mailing Address - Street 2:SUITE 221
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-1079
Mailing Address - Country:US
Mailing Address - Phone:972-660-1510
Mailing Address - Fax:972-988-9675
Practice Address - Street 1:2801 OSLER DR
Practice Address - Street 2:SUITE 221
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-1079
Practice Address - Country:US
Practice Address - Phone:972-660-1510
Practice Address - Fax:972-988-9675
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107857225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist