Provider Demographics
NPI:1285718544
Name:PRESSLER PHYSICAL THERAPY CLINIC
Entity type:Organization
Organization Name:PRESSLER PHYSICAL THERAPY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DALE
Authorized Official - Middle Name:R
Authorized Official - Last Name:PRESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:972-709-9191
Mailing Address - Street 1:402 W WHEATLAND RD
Mailing Address - Street 2:STE 100
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-4600
Mailing Address - Country:US
Mailing Address - Phone:972-709-9191
Mailing Address - Fax:972-709-2116
Practice Address - Street 1:402 W WHEATLAND RD
Practice Address - Street 2:STE 100
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-4600
Practice Address - Country:US
Practice Address - Phone:972-709-9191
Practice Address - Fax:972-709-2116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1022390261QP2000X
TX1023869261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0941745OtherCIGNA
TX0876389501Medicaid
TX5445569OtherAETNA
TX80251TOtherBLUECROSS BLUE SHEILD #
TX0044169OtherBLUELINK
TX4366891OtherAETNA
TX7369351OtherBLUELINK
80250TOtherBLUECROSS BLUE SHEILD #
TX650190Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
TX650191Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER