Healthcare Provider Details

I. General information

NPI: 1386454510
Provider Name (Legal Business Name): G3O THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2025
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14350 PROTON RD STE 230
FARMERS BRANCH TX
75244-3511
US

IV. Provider business mailing address

521 PARADISE CV
SHADY SHORES TX
76208-5139
US

V. Phone/Fax

Practice location:
  • Phone: 940-487-7712
  • Fax: 940-205-4480
Mailing address:
  • Phone: 972-740-2194
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: BETH E BERGERON
Title or Position: OWNER/MANAGER
Credential: OTR, CHT
Phone: 972-740-2194