Provider Demographics
NPI:1508259276
Name:STRYK, LANCE CHRISTOPHER (PT, DPT)
Entity Type:Individual
Prefix:
First Name:LANCE
Middle Name:CHRISTOPHER
Last Name:STRYK
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 1:4207 LIVE OAK ST APT 1119
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-6707
Mailing Address - Country:US
Mailing Address - Phone:832-247-7960
Mailing Address - Fax:
Practice Address - Street 1:1740 N COLLINS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3656
Practice Address - Country:US
Practice Address - Phone:972-235-9035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-05
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1256280225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist