Provider Demographics
NPI:1376979401
Name:PAPA, RIC (PT)
Entity Type:Individual
Prefix:
First Name:RIC
Middle Name:
Last Name:PAPA
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 1:6201 WINDHAVEN PKWY
Mailing Address - Street 2:APT. 3015
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8097
Mailing Address - Country:US
Mailing Address - Phone:972-403-7212
Mailing Address - Fax:
Practice Address - Street 1:6201 WINDHAVEN PKWY
Practice Address - Street 2:APT. 3015
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8097
Practice Address - Country:US
Practice Address - Phone:972-403-7212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-20
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1073658225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist