Provider Demographics
NPI:1891915716
Name:MCGRATH, RICHARD W (PT)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:W
Last Name:MCGRATH
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 N BUCKNER BLVD STE 118
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-2764
Mailing Address - Country:US
Mailing Address - Phone:214-324-5851
Mailing Address - Fax:214-324-5728
Practice Address - Street 1:718 N BUCKNER BLVD STE 118
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-2764
Practice Address - Country:US
Practice Address - Phone:214-324-5851
Practice Address - Fax:214-324-5728
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1106292225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1106292OtherPHYSICAL THERAPY LICENSE
1467497735OtherGROUP NPI #
TX8J6577Medicare PIN
TX00W771Medicare PIN