Provider Demographics
NPI:1275965188
Name:DEO, ABHIJEET (PT)
Entity Type:Individual
Prefix:MR
First Name:ABHIJEET
Middle Name:
Last Name:DEO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6243 RETAIL RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-7808
Mailing Address - Country:US
Mailing Address - Phone:214-890-9853
Mailing Address - Fax:214-890-9856
Practice Address - Street 1:1158 MICHENER WAY
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-5443
Practice Address - Country:US
Practice Address - Phone:214-784-1779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1197090225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist