Provider Demographics
NPI:1598720070
Name:PIGG, REGINA LOUISE (PT)
Entity Type:Individual
Prefix:MRS
First Name:REGINA
Middle Name:LOUISE
Last Name:PIGG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:REGINA
Other - Middle Name:LOUISE
Other - Last Name:JUSTUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7548 PRESTON RD
Mailing Address - Street 2:STE 145
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034
Mailing Address - Country:US
Mailing Address - Phone:972-712-9693
Mailing Address - Fax:972-712-9625
Practice Address - Street 1:7548 PRESTON RD
Practice Address - Street 2:STE 145
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034
Practice Address - Country:US
Practice Address - Phone:972-712-9693
Practice Address - Fax:972-712-9625
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1146501225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist