Provider Demographics
NPI:1710129192
Name:STAY STRONG PHYSICAL THERAPY - ARGYLE PLLC
Entity Type:Organization
Organization Name:STAY STRONG PHYSICAL THERAPY - ARGYLE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAZIEL
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MPT
Authorized Official - Phone:940-464-0055
Mailing Address - Street 1:PO BOX 372
Mailing Address - Street 2:
Mailing Address - City:ARGYLE
Mailing Address - State:TX
Mailing Address - Zip Code:76226-0372
Mailing Address - Country:US
Mailing Address - Phone:940-464-0055
Mailing Address - Fax:940-464-7755
Practice Address - Street 1:4809 COLE AVE STE 110
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-3553
Practice Address - Country:US
Practice Address - Phone:940-464-0055
Practice Address - Fax:940-464-7755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-31
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1161898261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0073QKOtherBCBS
TX0073QKOtherBCBS