Healthcare Provider Details

I. General information

NPI: 1245333418
Provider Name (Legal Business Name): PARK PLAZA PHYSICAL THERAPY LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4350 S NATIONAL AVE SUITE A108
SPRINGFIELD MO
65810-2607
US

IV. Provider business mailing address

1300 W SAM HOUSTON PKWY S SUITE 300
HOUSTON TX
77042-2447
US

V. Phone/Fax

Practice location:
  • Phone: 417-823-8670
  • Fax: 417-823-8625
Mailing address:
  • Phone: 713-297-7000
  • Fax: 713-297-7090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JANNA P. KING
Title or Position: VP,AUTHORIZED OFFICIAL
Credential: JD
Phone: 713-297-7000