Individual
AMGED GAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT. DPT.
Contact information
Practice address
2201 SPINKS RD STE 247, FLOWER MOUND, TX 75022-4499
(214) 425-0236
(469) 645-2041
Mailing address
2201 SPINKS RD STE 247, FLOWER MOUND, TX 75022-4499
(214) 425-0236
(469) 645-2041
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1372157
TX
Other
Enumeration date
03/06/2015
Last updated
10/04/2023
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