Provider Demographics
NPI:1437318110
Name:PEAK PHYSICAL THERAPY AND SPORTS MEDICINE CENTERS OF KYLE PLLC
Entity Type:Organization
Organization Name:PEAK PHYSICAL THERAPY AND SPORTS MEDICINE CENTERS OF KYLE PLLC
Other - Org Name:PEAK PHYSICAL THERAPY AND SPORTS MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:CORINA
Authorized Official - Last Name:DEAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:512-268-0000
Mailing Address - Street 1:21195 IH 35 NORTH
Mailing Address - Street 2:SUITE 201
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-1195
Mailing Address - Country:US
Mailing Address - Phone:512-268-0000
Mailing Address - Fax:512-523-5496
Practice Address - Street 1:21195 IH 35 NORTH
Practice Address - Street 2:SUITE 201
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-1195
Practice Address - Country:US
Practice Address - Phone:512-268-0000
Practice Address - Fax:512-268-0004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-06
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty