Provider Demographics
NPI:1861455909
Name:FALLON, PATRICK CHASE (PT)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:CHASE
Last Name:FALLON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2709 VIRGINIA PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-4917
Mailing Address - Country:US
Mailing Address - Phone:972-542-3300
Mailing Address - Fax:972-542-4311
Practice Address - Street 1:2709 VIRGINIA PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-4917
Practice Address - Country:US
Practice Address - Phone:972-542-3300
Practice Address - Fax:972-542-4311
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1063816225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX399397YN85Medicare PIN