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General NPI Number Information
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NPI Number | 1336907260
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Entity Type | Organization
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Legal Business Name | INNOVATIVE THERAPY P.C.
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Dates
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Enumeration Date | 03/06/2024
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Last Update Date | 03/06/2024
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Provider Practice Location Address
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Address Line | 13747 MONTFORT DR STE 160
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City | DALLAS
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State | TX
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Zip | 75240-4497
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Country | US
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Telephone | 214-225-8530
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Fax | 888-816-3627
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Provider Business Mailing Address
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Address Line | 13747 MONTFORT DR STE 160
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City | DALLAS
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State | TX
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Zip | 75240-4497
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Country | US
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Telephone | 214-225-8530
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MARY L. THOMAS
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Credential | PT
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Telephone | 214-225-8530
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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