MEDICARE: NOA PHYSICAL THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1328811	OTHER	TX	PT LICENSE

General Provider Information

NPI Number	:	1023698636
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOA PHYSICAL THERAPY LLC

Provider Business Mailing Address
First Line	:	2717 WINFIELD DR
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75023-7946
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5501 INDEPENDENCE PKWY STE 310
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75023-5471
Country	:	US
Telephone Number	:	412-273-0360
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	QI SUN
Credential	:	DPT
Telephone Number	:	412-273-0360

Provider Enumeration Date	:	04/09/2021
Last Update Date	:	04/09/2021

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Directions to “NOA PHYSICAL THERAPY LLC ” Practice Location

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