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General NPI Number Information
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NPI Number | 1083069801
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Entity Type | Organization
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Legal Business Name | PMST MANAGEMENT GROUP
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Dates
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Enumeration Date | 04/29/2016
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Last Update Date | 02/26/2021
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Provider Practice Location Address
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Address Line | 6101 WINDHAVEN PKWY STE 145
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City | PLANO
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State | TX
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Zip | 75093-8198
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Country | US
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Telephone | 972-473-8980
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Fax | 972-212-6851
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Provider Business Mailing Address
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Address Line | 6001 WINDHAVEN PKWY SUITE 210
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City | PLANO
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State | TX
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Zip | 75093-8017
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Country | US
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Telephone | 972-473-8980
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Fax | 972-212-6851
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Authorized Official
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Title or Position | CEO
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Name | DEREK GOVE
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Credential |
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Telephone | 972-473-8980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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