Provider Demographics
NPI:1437790177
Name:PK & K THERAPIES. LLC
Entity Type:Organization
Organization Name:PK & K THERAPIES. LLC
Other - Org Name:M3 PHYSICAL THERAPY RECHARGED PERFORMANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, CERT MDT
Authorized Official - Phone:469-814-8126
Mailing Address - Street 1:3930 NAAMAN SCHOOL RD STE D
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-0980
Mailing Address - Country:US
Mailing Address - Phone:469-814-8126
Mailing Address - Fax:972-905-5516
Practice Address - Street 1:3930 NAAMAN SCHOOL RD STE D
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-0980
Practice Address - Country:US
Practice Address - Phone:469-814-8126
Practice Address - Fax:972-905-5516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-03
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
932233OtherPTAN
TX1296763OtherPHYSICAL THERAPY LICENSE