MEDICARE: BCT THERAPY MANAGEMENT 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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1538878038
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BCT THERAPY MANAGEMENT LLC

Provider Business Mailing Address
First Line	:	732 S COPPELL RD
Second Line	:
City	:	COPPELL
State	:	TX
Zip	:	75019-4511
Country	:	US
Telephone Number	:	228-209-3371
Fax Number	:

Provider Business Practice Location Address
First Line	:	3930 GLADE RD STE 124
Second Line	:
City	:	COLLEYVILLE
State	:	TX
Zip	:	76034-5932
Country	:	US
Telephone Number	:	228-209-3371
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CAROL DOUGLAS
Credential	:
Telephone Number	:	214-728-9702

Provider Enumeration Date	:	11/23/2022
Last Update Date	:	11/23/2022

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Directions to “BCT THERAPY MANAGEMENT LLC ” Practice Location

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