Healthcare Provider Details

I. General information

NPI: 1619266509
Provider Name (Legal Business Name): ERNESTO LACIDA PAGLINAWAN PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2011
Last Update Date: 10/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8112 CAELAN CT
MCKINNEY TX
75071-6309
US

IV. Provider business mailing address

8112 CAELAN CT
MCKINNEY TX
75071-6309
US

V. Phone/Fax

Practice location:
  • Phone: 708-990-2250
  • Fax: 855-232-8604
Mailing address:
  • Phone: 708-990-2250
  • Fax: 855-232-8604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070017076
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1254686
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: