Healthcare Provider Details

I. General information

NPI: 1205264447
Provider Name (Legal Business Name): KRISTI ROSIPAL PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2013
Last Update Date: 01/11/2022
Certification Date: 01/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 MAPLESHADE LN STE 110
PLANO TX
75093-0032
US

IV. Provider business mailing address

4200 MAPLESHADE LN STE 110
PLANO TX
75093-0032
US

V. Phone/Fax

Practice location:
  • Phone: 972-735-0920
  • Fax: 972-735-0919
Mailing address:
  • Phone: 972-735-0920
  • Fax: 972-735-0919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number10910490
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: