Provider Demographics
NPI:1194947937
Name:LOVE, VERLON D (PT)
Entity type:Individual
Prefix:MR
First Name:VERLON
Middle Name:D
Last Name:LOVE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 866124
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75086-6124
Mailing Address - Country:US
Mailing Address - Phone:972-422-5223
Mailing Address - Fax:972-422-5791
Practice Address - Street 1:601 W PARKER RD
Practice Address - Street 2:SUITE 103
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-7019
Practice Address - Country:US
Practice Address - Phone:972-422-5223
Practice Address - Fax:972-422-5791
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1002459225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX650039Medicare ID - Type Unspecified