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General NPI Number Information
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NPI Number | 1467057687
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Entity Type | Organization
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Legal Business Name | HEALING PT
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Dates
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Enumeration Date | 12/04/2020
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 3786 FM 1488 RD STE 190
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City | CONROE
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State | TX
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Zip | 77384-4988
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Country | US
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Telephone | 214-390-7697
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Fax | 972-432-6692
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Provider Business Mailing Address
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Address Line | 400 STONEBROOK PKWY STE 1104-212
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City | FRISCO
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State | TX
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Zip | 75036-1179
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Country | US
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Telephone | 214-390-7697
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Fax | 972-432-6692
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Authorized Official
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Title or Position | ADMIN
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Name | JESSEN MUKALEL
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Credential | MD
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Telephone | 214-390-7697
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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 |
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License Number State |
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