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Organization
SOURCE 1 MEDICAL INC
Active
Organization
SOURCE 1 MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM GARRET HARRELL (CHIEF OPERATIONS OFFICER)
(214) 808-2724
Entity
Organization
Contact information
Practice address
8080 INDEPENDENCE PKWY STE 110A, PLANO, TX 75025-4000
(469) 658-0100
(469) 658-0101
Mailing address
PO BOX 251728, PLANO, TX 75025-1517
(972) 801-2190
(972) 801-2191
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
—
—
2084N0400X
Neurology Physician
—
—
2084N0600X
Clinical Neurophysiology Physician
—
—
225100000X
Physical Therapist
Primary
—
—
2251E1300X
Clinical Electrophysiology Physical Therapist
—
—
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
225XN1300X
Neurorehabilitation Occupational Therapist
—
—
225XP0019X
Physical Rehabilitation Occupational Therapist
—
—
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
11/01/2021
Last updated
05/12/2025
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