MEDICARE: MRS. SHANA PUGH PHYSICAL THERAPIST

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		TX

General Provider Information

NPI Number	:	1114009479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHANA PUGH PHYSICAL THERAPIST

Provider Business Mailing Address
First Line	:	1105 CENTRAL EXPY N
Second Line	:	MOB 2, SUITE 2250
City	:	ALLEN
State	:	TX
Zip	:	75013-6103
Country	:	US
Telephone Number	:	972-747-6900
Fax Number	:	972-747-6905

Provider Business Practice Location Address
First Line	:	1105 CENTRAL EXPY N
Second Line	:
City	:	ALLEN
State	:	TX
Zip	:	75013-6103
Country	:	US
Telephone Number	:	972-747-6900
Fax Number	:	972-747-6905

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	06/26/2026

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