# IDEAL PHYSICAL THERAPY OF TEXAS LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093349342
- **Authorized official:** MATT KIRK (DIRECTOR)
- **Authorized official phone:** (708) 710-9931

## Contact information

- **Practice address:** 12222 COIT RD STE 200, DALLAS, TX 75251-2302
- **Practice address phone:** (972) 979-6577
- **Mailing address:** 790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
- **Mailing address phone:** (630) 296-2223

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 02/26/2020
- **Last updated:** 02/26/2020