Healthcare Provider Details

I. General information

NPI: 1104570423
Provider Name (Legal Business Name): BALANCED CREATIONS PHYSICAL THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2022
Last Update Date: 05/11/2024
Certification Date: 05/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 MIKUS RD
HUDSON OAKS TX
76087-7989
US

IV. Provider business mailing address

2222 BURGUNDY DR
CARROLLTON TX
75006-4324
US

V. Phone/Fax

Practice location:
  • Phone: 214-500-0126
  • Fax: 817-290-3876
Mailing address:
  • Phone: 214-500-0126
  • Fax: 972-440-2059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: SIGOURNEY DOWNS WEATHERS
Title or Position: MANAGING MEMBER
Credential: PT, DPT
Phone: 214-500-0126