Provider Demographics
NPI:1508233792
Name:PHYSIOPLAY THERAPIES, PLLC
Entity Type:Organization
Organization Name:PHYSIOPLAY THERAPIES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLEAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MPT, C/NDT
Authorized Official - Phone:469-400-8232
Mailing Address - Street 1:104 N GREENVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-2236
Mailing Address - Country:US
Mailing Address - Phone:469-400-8232
Mailing Address - Fax:469-795-6388
Practice Address - Street 1:104 N GREENVILLE AVE
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-2236
Practice Address - Country:US
Practice Address - Phone:469-400-8232
Practice Address - Fax:469-795-6388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12437402251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty