Healthcare Provider Details

I. General information

NPI: 1063646180
Provider Name (Legal Business Name): PEAK PHYSICAL THERAPY AND SPORTS MEDICINE CENTER OF FRISCO, P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2009
Last Update Date: 08/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3010 GAYLORD PKWY STE. 140
FRISCO TX
75034-8664
US

IV. Provider business mailing address

PO BOX 674172
DALLAS TX
75267-4172
US

V. Phone/Fax

Practice location:
  • Phone: 972-377-4111
  • Fax: 972-377-4148
Mailing address:
  • Phone: 214-369-8555
  • Fax: 214-369-2683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. JAY R ESTES
Title or Position: MANAGING PARTNER
Credential: P.T.
Phone: 972-377-4111