Provider Demographics
NPI:1477183663
Name:LACORE, STEVEN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:LACORE
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4821 MOUNTAIN RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-7898
Mailing Address - Country:US
Mailing Address - Phone:972-786-4110
Mailing Address - Fax:
Practice Address - Street 1:5700 DALLAS PKWY
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-9580
Practice Address - Country:US
Practice Address - Phone:469-515-7265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1308130225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist