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General NPI Number Information
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NPI Number | 1114257748
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Entity Type | Organization
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Legal Business Name | HCW ELITE PHYSICAL THERAPY, INC
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Dates
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Enumeration Date | 01/04/2010
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Last Update Date | 06/28/2010
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Provider Practice Location Address
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Address Line | 1711 HERITAGE PKWY SUITE 100
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City | SHERMAN
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State | TX
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Zip | 75092-7163
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Country | US
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Telephone | 903-328-6876
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Fax | 903-870-1425
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Provider Business Mailing Address
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Address Line | 1711 HERITAGE PKWY SUITE 100
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City | SHERMAN
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State | TX
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Zip | 75092-7163
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Country | US
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Telephone | 903-328-6876
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Fax | 903-870-1425
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Authorized Official
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Title or Position | OWNER/PT
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Name | NAN HARRIS
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Credential |
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Telephone | 903-328-6876
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 1055390
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License Number State | TX
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