Provider Demographics
NPI:1972295350
Name:DICK'S BIGHEART, LLC
Entity Type:Organization
Organization Name:DICK'S BIGHEART, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:
Authorized Official - Last Name:GEYMER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:817-201-9656
Mailing Address - Street 1:217 HARWOOD RD STE 215
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-4100
Mailing Address - Country:US
Mailing Address - Phone:817-393-7740
Mailing Address - Fax:
Practice Address - Street 1:217 HARWOOD RD STE 215
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-4100
Practice Address - Country:US
Practice Address - Phone:817-393-7740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurologyGroup - Multi-Specialty