Organization
RICHARDSON PHYSICAL THERAPY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD AARON BENNETT P.T. (OWNER)
(972) 235-3874
Entity
Organization
Contact information
Practice address
515 W CAMPBELL RD, SUITE 105, RICHARDSON, TX 75080-3374
(972) 235-3874
(972) 235-9720
Mailing address
515 W CAMPBELL RD, SUITE 105, RICHARDSON, TX 75080-3374
(972) 235-3874
(972) 235-9720
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
1031847
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0086JW
BLUE CROSS BLUE SHIELD
TX
Enumeration date
05/07/2007
Last updated
08/22/2020
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