Healthcare Provider Details

I. General information

NPI: 1235972183
Provider Name (Legal Business Name): BRETT ALLEN GEORGE PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2024
Last Update Date: 06/18/2024
Certification Date: 06/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1313 N TRAVIS ST STE 104
SHERMAN TX
75092-5165
US

IV. Provider business mailing address

2911 CENTRAL EXPY APT 9302
MELISSA TX
75454-2445
US

V. Phone/Fax

Practice location:
  • Phone: 469-963-1771
  • Fax: 214-377-6243
Mailing address:
  • Phone: 913-369-5187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1393319
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: