Provider Demographics
NPI:1922019116
Name:PITMAN CREEK PHYSICAL THERAPY P C
Entity Type:Organization
Organization Name:PITMAN CREEK PHYSICAL THERAPY P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-424-5840
Mailing Address - Street 1:700 ALMA DR
Mailing Address - Street 2:STE 135
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-8807
Mailing Address - Country:US
Mailing Address - Phone:972-424-5840
Mailing Address - Fax:972-423-9427
Practice Address - Street 1:700 ALMA DR
Practice Address - Street 2:STE 135
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-8807
Practice Address - Country:US
Practice Address - Phone:972-424-5840
Practice Address - Fax:972-423-9427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX605150000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00420EMedicare ID - Type UnspecifiedPHYSICAL THERAPY