Provider Demographics
NPI:1386769123
Name:ALLEN PHYSICAL THERAPY
Entity type:Organization
Organization Name:ALLEN PHYSICAL THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:QWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:BYRON
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:972-727-9888
Mailing Address - Street 1:202 N ALLEN DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013
Mailing Address - Country:US
Mailing Address - Phone:972-727-9888
Mailing Address - Fax:972-727-9909
Practice Address - Street 1:202 N ALLEN DR
Practice Address - Street 2:SUITE C
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013
Practice Address - Country:US
Practice Address - Phone:972-727-9888
Practice Address - Fax:972-727-9909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
TX656790000261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty