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General NPI Number Information
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NPI Number | 1265133128
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Entity Type | Organization
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Legal Business Name | FLOWER MOUND PHYSICAL THERAPY
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Dates
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Enumeration Date | 03/16/2023
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 635 PARKER SQUARE
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City | FLOWER MOUND
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State | TX
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Zip | 75028
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Country | US
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Telephone | 469-222-4595
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Fax |
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Provider Business Mailing Address
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Address Line | 11215 DWARFS CIR
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City | DALLAS
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State | TX
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Zip | 75229-4020
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Country | US
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Telephone | 469-222-4595
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GINA TOMASESKI
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Credential | PT, DPT
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Telephone | 469-222-4595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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