Healthcare Provider Details

I. General information

NPI: 1467625970
Provider Name (Legal Business Name): SUMMIT THERAPEUTIC CONCEPTS OF PLANO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2008
Last Update Date: 10/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 PRESTON RD SUITE 250
PLANO TX
75093-5186
US

IV. Provider business mailing address

PO BOX 660046
DALLAS TX
75266-0046
US

V. Phone/Fax

Practice location:
  • Phone: 972-596-4800
  • Fax: 972-596-4822
Mailing address:
  • Phone: 214-369-8555
  • Fax: 214-369-2683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. STEVEN COLE
Title or Position: PARTNER
Credential: PT
Phone: 972-596-4800