Provider Demographics
NPI:1851322721
Name:ORTHOPEDIC MANUAL PHYSICAL THERAPY INSTITUTE OF DALLAS INC
Entity Type:Organization
Organization Name:ORTHOPEDIC MANUAL PHYSICAL THERAPY INSTITUTE OF DALLAS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:D
Authorized Official - Last Name:SILLIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-346-0677
Mailing Address - Street 1:8144 WALNUT HILL LN
Mailing Address - Street 2:STE 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4388
Mailing Address - Country:US
Mailing Address - Phone:214-346-0677
Mailing Address - Fax:
Practice Address - Street 1:8144 WALNUT HILL LN
Practice Address - Street 2:STE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4388
Practice Address - Country:US
Practice Address - Phone:214-346-0677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0085HVOtherBCBS
TX00693UMedicare PIN
TX0A6163Medicare PIN
TX0085HVOtherBCBS
TXDE8353Medicare PIN