Provider Demographics
NPI:1184846479
Name:PEAK PHYSICAL THERAPY & SPORTS MEDICINE CENTER OF SHERMAN
Entity type:Organization
Organization Name:PEAK PHYSICAL THERAPY & SPORTS MEDICINE CENTER OF SHERMAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER CHIEF PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:GLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-892-4800
Mailing Address - Street 1:2021 HWY 1417 N
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2021 HWY 1417 N
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092
Practice Address - Country:US
Practice Address - Phone:903-892-4800
Practice Address - Fax:903-892-4444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1015568261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy