Provider Demographics
NPI:1770061632
Name:ABBOTT, CODY (DPT)
Entity type:Individual
Prefix:
First Name:CODY
Middle Name:
Last Name:ABBOTT
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
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Mailing Address - Street 1:2114 TEXOMA PKWY STE 650
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-2692
Mailing Address - Country:US
Mailing Address - Phone:039-813-1551
Mailing Address - Fax:903-813-1725
Practice Address - Street 1:2114 TEXOMA PKWY STE 650
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-2692
Practice Address - Country:US
Practice Address - Phone:903-813-1551
Practice Address - Fax:903-813-1725
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-02
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1306652261QP2000X, 208100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation