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  7. NPI Record 1588877757

RICHARDSON PHYSICAL THERAPY CLINIC
Complete NPI Record 1588877757
Clinic/Center - Physical Therapy in Richardson, TX

NPI Status: Active since May 07, 2007

Contact Information

515 W CAMPBELL RD
SUITE 105
RICHARDSON, TX
ZIP 75080
Phone: (972) 235-3874
Fax: (972) 235-9720

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Second Line Business Mailing Address
  7. Provider Business Mailing Address City Name
  8. Provider Business Mailing Address State Name
  9. Provider Business Mailing Address Postal Code
  10. Provider Business Mailing Address Country Code If outside U S
  11. Provider Business Mailing Address Telephone Number
  12. Provider Business Mailing Address Fax Number
  13. Provider First Line Business Practice Location Address
  14. Provider Second Line Business Practice Location Address
  15. Provider Business Practice Location Address City Name
  16. Provider Business Practice Location Address State Name
  17. Provider Business Practice Location Address Postal Code
  18. Provider Business Practice Location Address Country Code If outside U S
  19. Provider Business Practice Location Address Telephone Number
  20. Provider Business Practice Location Address Fax Number
  21. Provider Enumeration Date
  22. Last Update Date
  23. Authorized Official Last Name
  24. Authorized Official First Name
  25. Authorized Official Middle Name
  26. Authorized Official Title or Position
  27. Authorized Official Telephone Number
  28. Healthcare Provider Taxonomy Code 1
  29. Provider License Number 1
  30. Provider License Number State Code 1
  31. Healthcare Provider Primary Taxonomy Switch 1
  32. Other Provider Identifier 1
  33. Other Provider Identifier Type Code 1
  34. Other Provider Identifier State 1
  35. Other Provider Identifier Issuer 1
  36. Is Organization Subpart
  37. Authorized Official Credential Text

Complete NPI Dataset

This page represents the complete record for NPI 1588877757. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1588877757
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Employer Identification Number EIN: UNAVAIL
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider First Line Business Mailing Address: 515 W CAMPBELL RD
The city name in the location address of the provider being identified.
Provider Second Line Business Mailing Address: SUITE 105
The State code in the location of the provider being identified.
Provider Business Mailing Address City Name: RICHARDSON
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Mailing Address State Name: TX
The country code in the location address of the provider being identified.
Provider Business Mailing Address Postal Code: 750803374
The telephone number associated with the location address of the provider being identified.
Provider Business Mailing Address Country Code If outside U S : US
The date the provider was assigned a unique identifier (assigned an NPI).
Provider Business Mailing Address Telephone Number: 9722353874
The code designating the provider’s gender if the provider is a person.
Provider Business Mailing Address Fax Number: 9722359720
The code designating the provider’s gender if the provider is a person.
Provider First Line Business Practice Location Address: 515 W CAMPBELL RD
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider Second Line Business Practice Location Address: SUITE 105
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider Business Practice Location Address City Name: RICHARDSON
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: TX
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 750803374
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 9722353874
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 9722359720
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 5/7/2007
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 8/22/2020
The date that a record was last updated or changed.
Authorized Official Last Name: BENNETT
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Authorized Official First Name: RICHARD
The last name of the provider. If the provider is an individual, this is the legal name.
Authorized Official Middle Name: AARON
The middle name of the authorized official.
Authorized Official Title or Position: OWNER
The title or position of the authorized official.
Authorized Official Telephone Number: 9722353874
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 261QP2000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 1031847
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: TX
The city name in the location address of the provider being identified.
Healthcare Provider Primary Taxonomy Switch 1: Y
The State code in the location of the provider being identified.
Other Provider Identifier 1: 0086JW
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Other Provider Identifier Type Code 1: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1: TX
Other Provider Identifier Issuer 1: BLUE CROSS BLUE SHIELD
Is Organization Subpart: N
Authorized Official Credential Text: P.T.