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General NPI Number Information
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NPI Number | 1255505871
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Entity Type | Organization
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Legal Business Name | SPARKS THERAPY SERVICES, PLLC
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Dates
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Enumeration Date | 04/15/2008
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Last Update Date | 12/16/2008
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Provider Practice Location Address
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Address Line | 1506 PARK RIDGE TER
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City | ARLINGTON
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State | TX
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Zip | 76012-1929
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Country | US
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Telephone | 817-461-3331
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Fax | 817-461-3331
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Provider Business Mailing Address
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Address Line | PO BOX 122450
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City | ARLINGTON
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State | TX
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Zip | 76012-8450
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/MANAGING MEMBER
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Name | SUSAN L. SPARKS
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Credential |
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Telephone | 214-597-8188
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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 | 1169113
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1121283
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 102442
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2057623
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2030625
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 15474
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License Number State | TX
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Taxonomy #7
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 15357
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License Number State | TX
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Taxonomy #8
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1049997
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License Number State | TX
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