Provider Demographics
NPI:1407869506
Name:PENCSAK, PATRICIA SUSANNE (PT)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:SUSANNE
Last Name:PENCSAK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7001 W PARKER RD
Mailing Address - Street 2:APT. #836
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8614
Mailing Address - Country:US
Mailing Address - Phone:214-356-7559
Mailing Address - Fax:
Practice Address - Street 1:7001 W PARKER RD
Practice Address - Street 2:APT. #836
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8614
Practice Address - Country:US
Practice Address - Phone:214-356-7559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1160936225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist