Provider Demographics
NPI:1275828543
Name:FORD, TED J
Entity Type:Individual
Prefix:
First Name:TED
Middle Name:J
Last Name:FORD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 ELM ST
Mailing Address - Street 2:
Mailing Address - City:PILOT POINT
Mailing Address - State:TX
Mailing Address - Zip Code:76258-2741
Mailing Address - Country:US
Mailing Address - Phone:940-536-7718
Mailing Address - Fax:972-422-8315
Practice Address - Street 1:6829 K AVE STE 105
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-2542
Practice Address - Country:US
Practice Address - Phone:972-422-8280
Practice Address - Fax:972-422-8315
Is Sole Proprietor?:No
Enumeration Date:2011-06-15
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXATP1625247200000X
225CA2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225CA2400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorAssistive Technology Practitioner
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other