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General NPI Number Information
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NPI Number | 1285872788
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE PEDIATRIC THERAPY OF TX, INC.
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Dates
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Enumeration Date | 01/22/2009
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Last Update Date | 01/22/2009
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Provider Practice Location Address
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Address Line | 2233 DAMPTON DR
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City | PLANO
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State | TX
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Zip | 75025-2470
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Country | US
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Telephone | 214-704-9994
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Fax | 972-208-4825
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Provider Business Mailing Address
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Address Line | 2233 DAMPTON DR
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City | PLANO
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State | TX
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Zip | 75025-2470
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Country | US
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Telephone | 214-704-9994
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Fax | 972-208-4825
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. NENEITTE TABANI
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Credential | OTR
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Telephone | 214-704-9994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 110058
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License Number State | TX
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