Healthcare Provider Details

I. General information

NPI: 1326912692
Provider Name (Legal Business Name): KELSEY MCGINNIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2025
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1333 CORPORATE DR STE 245
IRVING TX
75038-7514
US

IV. Provider business mailing address

3424 CEDAR MEADOWS LN
VAN ALSTYNE TX
75495-2237
US

V. Phone/Fax

Practice location:
  • Phone: 214-591-0061
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1224646
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: