MEDICARE: COMPETITIVE EDGE SPORTS MED, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1235924598
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPETITIVE EDGE SPORTS MED, LLC

Provider Business Mailing Address
First Line	:	6541 COLLIN MCKINNEY PKWY STE 106
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75070-2726
Country	:	US
Telephone Number	:	214-233-6445
Fax Number	:

Provider Business Practice Location Address
First Line	:	6541 COLLIN MCKINNEY PKWY STE 106
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75070-2726
Country	:	US
Telephone Number	:	214-253-9201
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER/OWNER
Name	:	JACQUELYN GARCES
Credential	:	PT
Telephone Number	:	408-306-3336

Provider Enumeration Date	:	04/09/2025
Last Update Date	:	06/04/2026

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