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General NPI Number Information
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NPI Number | 1053550004
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Entity Type | Individual
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Provider Name | READE ERIC WHITNEY ATC
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Gender | Male
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Dates
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Enumeration Date | 02/16/2009
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Last Update Date | 07/31/2015
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Provider Practice Location Address
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Address Line | 9200 WORLD CUP WAY SUITE 202
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City | FRISCO
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State | TX
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Zip | 75033-4950
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Country | US
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Telephone | 813-830-8065
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Fax |
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Provider Business Mailing Address
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Address Line | 1750 FM 423 #754
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City | FRISCO
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State | TX
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Zip | 75033-0507
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Country | US
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Telephone | 813-830-8065
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT5711
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License Number State | TX
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