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NPI Code Detail

MEDICARE: PEDIATRIC THERAPY WORKS, PLLC

MEDICARE: PEDIATRIC THERAPY WORKS, 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
1225100000XPhysical Therapist
2225XP0200XPediatric Occupational Therapist
3225X00000XOccupational Therapist
42251P0200XPediatric Physical Therapist
5235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1831574185
Entity Type Code : Organization
Provider Name (Legal Business Name) : PEDIATRIC THERAPY WORKS, PLLC
Provider Business Mailing Address
First Line : 370 GREEN HOLLOW DR
Second Line :
City : TEMPLE
State : TX
Zip : 76502-6126
Country : US
Telephone Number : 254-760-5830
Fax Number : 254-780-9663
Provider Business Practice Location Address
First Line : 370 GREEN HOLLOW DR
Second Line :
City : TEMPLE
State : TX
Zip : 76502-6126
Country : US
Telephone Number : 254-760-5830
Fax Number :
Authorized Official
Title or Position : OWNER
Name : LORIE MALONE
Credential : MS, CCC-SLP
Telephone Number : 254-780-9658
Provider Enumeration Date : 07/28/2015
Last Update Date : 04/30/2026

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1316123805 — KELLY KAY GUILLORY OTR
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