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NPI Code Detail

MEDICARE: KOKORO BODY THERAPIES, PLLC

MEDICARE: KOKORO BODY THERAPIES, PLLC
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
1207R00000XInternal Medicine Physician
2251E00000XHome Health Agency
3261QP2000XPhysical Therapy Clinic/Center
4261QR0400XRehabilitation Clinic/Center
5261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1245712421
Entity Type Code : Organization
Provider Name (Legal Business Name) : KOKORO BODY THERAPIES, PLLC
Provider Business Mailing Address
First Line : 14850 MONTFORT DR STE 140
Second Line :
City : DALLAS
State : TX
Zip : 75254-7077
Country : US
Telephone Number : 972-201-3552
Fax Number : 877-658-8663
Provider Business Practice Location Address
First Line : 14850 MONTFORT DR STE 181
Second Line : LB 11
City : DALLAS
State : TX
Zip : 75254-1450
Country : US
Telephone Number : 469-431-5656
Fax Number : 214-446-6010
Authorized Official
Title or Position : MANAGING MEMBER
Name : MS. ADRIANE ALEXANDER
Credential :
Telephone Number : 214-550-1469
Provider Enumeration Date : 09/04/2018
Last Update Date : 04/28/2025

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Directions to “KOKORO BODY THERAPIES, PLLC ” Practice Location

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