Provider Demographics
NPI:1417991514
Name:NORTH DALLAS PHYSICAL THERAPY ASSOCIATES PC
Entity Type:Organization
Organization Name:NORTH DALLAS PHYSICAL THERAPY ASSOCIATES PC
Other - Org Name:NORTH DALLAS PHYSICAL THERAPY AND WORK HARDENING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:GOLDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-644-7824
Mailing Address - Street 1:335 ROSELANE ST NW
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-7902
Mailing Address - Country:US
Mailing Address - Phone:470-259-5226
Mailing Address - Fax:267-321-2044
Practice Address - Street 1:510 N COIT RD
Practice Address - Street 2:SUITE 2035
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-5437
Practice Address - Country:US
Practice Address - Phone:972-437-2048
Practice Address - Fax:972-480-8514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX676575Medicare Oscar/Certification