Organization
THE KNEAD PHYSICAL MEDICINE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DAKOTA BLACK HAWKE (DIRECTOR OF OPERATIONS & FINANCE)
(469) 213-2762
Entity
Organization
Contact information
Practice address
13465 INWOOD RD, STE 120-130, FARMERS BRANCH, TX 75244
(469) 213-2762
Mailing address
4944 PRESTON ROAD, STE 100A, FRISCO, TX 75034
(469) 213-2762
Taxonomy
Speciality
Code
Description
License number
State
132700000X
Dietary Manager
—
—
207K00000X
Allergy & Immunology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
02/16/2017
Last updated
02/16/2017
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