Provider Demographics
NPI:1760524607
Name:PEAK PHYSICAL THERAPY AND SPORTS MEDICINE CENTERS OF FORNEY, PLLC
Entity Type:Organization
Organization Name:PEAK PHYSICAL THERAPY AND SPORTS MEDICINE CENTERS OF FORNEY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MPT
Authorized Official - Phone:972-564-3390
Mailing Address - Street 1:104 E. US HIGHWAY 80
Mailing Address - Street 2:SUITE 180
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126
Mailing Address - Country:US
Mailing Address - Phone:972-564-3390
Mailing Address - Fax:972-564-3399
Practice Address - Street 1:104 E. US HIGHWAY 80
Practice Address - Street 2:SUITE 180
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126
Practice Address - Country:US
Practice Address - Phone:972-564-3390
Practice Address - Fax:972-564-3399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1155770225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty