Provider Demographics
NPI:1992166581
Name:GREATER LEWISVILLE THERAPY CENTER INC
Entity type:Organization
Organization Name:GREATER LEWISVILLE THERAPY CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER-GTC
Authorized Official - Prefix:
Authorized Official - First Name:DENA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:AITKEN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:972-420-6605
Mailing Address - Street 1:966 N GARDEN RIDGE BLVD
Mailing Address - Street 2:SUITE 530
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-2827
Mailing Address - Country:US
Mailing Address - Phone:972-420-6605
Mailing Address - Fax:972-436-2770
Practice Address - Street 1:5950 BRYANT IRVIN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-4210
Practice Address - Country:US
Practice Address - Phone:817-294-4646
Practice Address - Fax:844-364-1297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-10
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX619640014225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty