Provider Demographics
NPI:1467057687
Name:HEALING PT
Entity Type:Organization
Organization Name:HEALING PT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:JESSEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MUKALEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-390-7697
Mailing Address - Street 1:3004 COMMUNICATIONS PKWY STE 200-212
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8909
Mailing Address - Country:US
Mailing Address - Phone:214-390-7697
Mailing Address - Fax:972-432-6692
Practice Address - Street 1:10857 KUYKENDAHL RD STE 120
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77382-2937
Practice Address - Country:US
Practice Address - Phone:214-390-7697
Practice Address - Fax:972-432-6692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-04
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty