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General NPI Number Information
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NPI Number | 1588439939
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Entity Type | Individual
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Provider Name | PHILIP JAMES SHEEDY PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 11/15/2023
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Last Update Date | 11/15/2023
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Provider Practice Location Address
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Address Line | 1110 RAINTREE CIR STE 1200
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City | ALLEN
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State | TX
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Zip | 75013-5982
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Country | US
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Telephone | 972-747-6300
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Fax |
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Provider Business Mailing Address
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Address Line | 916 TALBOTT LN APT 2124
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City | FORT WORTH
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State | TX
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Zip | 76102-2036
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Country | US
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Telephone | 802-233-2535
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 1309485
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License Number State | TX
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