=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235230681
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FOCUS PHYSICAL THERAPY, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/26/2006
-----------------------------------------------------
Last Update Date | 10/18/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5575 WARREN PKWY SUITE 310
-----------------------------------------------------
City | FRISCO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75034-4062
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-618-6480
-----------------------------------------------------
Fax | 214-618-6481
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5575 WARREN PKWY SUITE 310
-----------------------------------------------------
City | FRISCO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75034-4062
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-618-6480
-----------------------------------------------------
Fax | 214-618-6481
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLINIC MANAGER
-----------------------------------------------------
Name | MS. DEBRA SUE LAFERNEY
-----------------------------------------------------
Credential | PT/RMT
-----------------------------------------------------
Telephone | 214-618-6480
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 1028942
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------