MEDICARE: FOUNDATION HEALTH PHYSICAL THERAPY

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	657780000	TX

General Provider Information

NPI Number	:	1629002746
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOUNDATION HEALTH PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	8380 WARREN PKWY
Second Line	:	502
City	:	FRISCO
State	:	TX
Zip	:	75034-4198
Country	:	US
Telephone Number	:	214-618-8075
Fax Number	:	214-618-8055

Provider Business Practice Location Address
First Line	:	8380 WARREN PKWY
Second Line	:	502
City	:	FRISCO
State	:	TX
Zip	:	75034-4198
Country	:	US
Telephone Number	:	214-618-8075
Fax Number	:	214-618-8055

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. SHANE HERNANDEZ
Credential	:	MPT
Telephone Number	:	214-618-8075

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	06/20/2012

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Directions to “FOUNDATION HEALTH PHYSICAL THERAPY ” Practice Location

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