Provider Demographics
NPI:1346434222
Name:MCGUIRE, RICHARD J JR (PT)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:J
Last Name:MCGUIRE
Suffix:JR
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 1:3209 WILLOW CREEK WAY
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-2963
Mailing Address - Country:US
Mailing Address - Phone:817-233-6825
Mailing Address - Fax:
Practice Address - Street 1:2304 BARDIN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-3850
Practice Address - Country:US
Practice Address - Phone:972-606-0477
Practice Address - Fax:972-606-0244
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1018547225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist