Provider Demographics
NPI:1417340001
Name:GAD, AMGED (PT DPT)
Entity Type:Individual
Prefix:
First Name:AMGED
Middle Name:
Last Name:GAD
Suffix:
Gender:M
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 SPINKS RD STE 247
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022-4499
Mailing Address - Country:US
Mailing Address - Phone:214-425-0236
Mailing Address - Fax:469-645-2041
Practice Address - Street 1:2201 SPINKS RD STE 247
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-4499
Practice Address - Country:US
Practice Address - Phone:214-425-0236
Practice Address - Fax:469-645-2041
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-06
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1372157225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist