Provider Demographics
NPI:1245553395
Name:MEREDITH S. TITTLE, P.T., LLC
Entity type:Organization
Organization Name:MEREDITH S. TITTLE, P.T., LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:SCHUCK
Authorized Official - Last Name:TITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:940-241-1215
Mailing Address - Street 1:4040 BRYCE LN
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75077-7038
Mailing Address - Country:US
Mailing Address - Phone:940-241-1215
Mailing Address - Fax:940-455-2041
Practice Address - Street 1:4040 BRYCE LN
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75077-7038
Practice Address - Country:US
Practice Address - Phone:940-241-1215
Practice Address - Fax:940-455-2041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-03
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty