Healthcare Provider Details

I. General information

NPI: 1780122440
Provider Name (Legal Business Name): BAGGERLEY THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2017
Last Update Date: 02/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1673 VAUGHAN CT
DALLAS TX
75208-0107
US

IV. Provider business mailing address

1673 VAUGHAN CT
DALLAS TX
75208-0107
US

V. Phone/Fax

Practice location:
  • Phone: 214-675-5609
  • Fax: 214-242-8078
Mailing address:
  • Phone: 214-675-5609
  • Fax: 214-242-8078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License Number111798
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code225XL0004X
TaxonomyLow Vision Occupational Therapist
License Number111798
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number111798
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number111798
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number111798
License Number StateTX
# 6
Primary TaxonomyN
Taxonomy Code225XR0403X
TaxonomyDriving and Community Mobility Occupational Therapist
License Number111798
License Number StateTX
# 7
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number111798
License Number StateTX

VIII. Authorized Official

Name: RYAN BAGGERLEY
Title or Position: OWNER, OCCUPATIONAL THERAPIST
Credential: MOTR
Phone: 214-675-5609