Provider Demographics
NPI:1790727576
Name:THERAPYCARE, INC
Entity Type:Organization
Organization Name:THERAPYCARE, INC
Other - Org Name:PARK CITIES PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TISKO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:214-351-2299
Mailing Address - Street 1:3844 MARTHA LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-6126
Mailing Address - Country:US
Mailing Address - Phone:214-351-2299
Mailing Address - Fax:
Practice Address - Street 1:5930 LYNDON B JOHNSON FWY
Practice Address - Street 2:STE. 380
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6304
Practice Address - Country:US
Practice Address - Phone:214-351-2299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6132700261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00X042Medicare ID - Type Unspecified