Organization
KNEAD PHYSICAL MEDICINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CHRISTINA PONCE DE LEON (EXECUTIVE ADMINISTRATOR)
(214) 448-1066
Entity
Organization
Contact information
Practice address
4944 PRESTON RD, STE 100A, FRISCO, TX 75034-8597
(469) 304-3443
Mailing address
4944 PRESTON RD, STE 100A, FRISCO, TX 75034-8597
(469) 304-3443
Taxonomy
Speciality
Code
Description
License number
State
132700000X
Dietary Manager
—
—
207K00000X
Allergy & Immunology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
225700000X
Massage Therapist
—
—
Other
Enumeration date
04/25/2016
Last updated
09/24/2019
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