Provider Demographics
NPI:1699557009
Name:IPA PHYSIO DALLAS
Entity type:Organization
Organization Name:IPA PHYSIO DALLAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMENTROUT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:972-965-7128
Mailing Address - Street 1:8105 RASOR BLVD STE 243
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-0341
Mailing Address - Country:US
Mailing Address - Phone:469-782-9978
Mailing Address - Fax:469-782-9946
Practice Address - Street 1:8105 RASOR BLVD STE 243
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-0341
Practice Address - Country:US
Practice Address - Phone:469-782-9978
Practice Address - Fax:469-782-9946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty