Active NPI
Justin Frazier
- Physical Therapist
- Southlake, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1321645
- Practice address
- 190 SH-114 W
Southlake, TX 75609 - Phone
- (210) 882-2433
- NPI assigned
- Nov 13, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1321645 | TX | Primary |
Addresses
Primary practice location
190 SH-114 W
Southlake, TX 75609
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1288 W Main St
Suite 148
Lewisville, TX 75067-3468
Phone (469) 496-3992
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.56 of 100
- Quality
- 89.48
- Improvement activities
- 40
- Cost
- 71.16
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1321645 | TX | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ideal Physical Therapy of Texas LLC | Current | Accepting new patients | |
| Ideal Physical Therapy of Texas LLC | Physical Therapist | Current | Accepting new patients |
Locations
790 Remington Blvd
Bolingbrook, IL 60440
17051 Dallas Pkwy
Ste 450
Addison, TX 75001
Phone (214) 272-8561
5335 W Sublett Rd
Ste 151
Arlington, TX 76017
Phone (817) 839-9150
1827 SW Green Oaks Blvd
Ste 143
Arlington, TX 76017
Phone (512) 501-4783
3000 FM 407 E
Ste 500
Bartonville, TX 76226
Phone (940) 448-2007
6080 Southwest Blvd
Benbrook, TX 76109
Phone (817) 731-9331
4100 Fairway Dr
Ste 400
Carrollton, TX 75010
Phone (972) 394-3325
4843 Colleyville Blvd
Ste 221
Colleyville, TX 76034
Phone (817) 576-7520
5017 Teasley Ln
Ste 161
Denton, TX 76210
Phone (940) 220-2283
1050 Flower Mound Rd
Ste 140
Flower Mound, TX 75028
Phone (469) 702-5947
7410 McCart Ave
Ste 108
Fort Worth, TX 76133
Phone (682) 350-4318
1540 Eastchase Pkwy
Ste 4A
Fort Worth, TX 76120
4617 W Bailey Boswell Rd
Fort Worth, TX 76179
Phone (682) 350-4106
7260 Blue Mound Rd
Ste 146
Fort Worth, TX 76131
Phone 68228593508830
2600 W 7th St
Ste 137
Fort Worth, TX 76107
Phone (682) 233-6462
217 E Bonds Ranch Rd
Fort Worth, TX 76131
Phone (682) 285-9310
1401 William D Tate Ave
Ste 300
Grapevine, TX 76051
Phone (817) 527-3377
861 North Tarrant Pkwy
Unit 100
Keller, TX 76248
Phone (817) 918-2480
1288 W Main St
Ste 148
Lewisville, TX 75067
Phone (469) 496-3992
3141 E Broad St
Ste 111
Mansfield, TX 76063
Phone (817) 435-5248
5121 Rufe Snow Dr
Ste 110
North Richland Hills, TX 76180
Phone (817) 345-4367
3903 Wiseman Blvd
Ste 311
San Antonio, TX 78251
Phone (210) 593-0578
245 W State Highway 114
Ste 320
Southlake, TX 76092
Phone (817) 873-5311
5400 Brodie Ln
Ste 295
Sunset Valley, TX 78745
Phone (512) 676-3949
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- Physical Therapist
- Plano, TX
- NPI 1538573746
-
- Durable Medical Equipment & Medical Supplies
- Murphy, TX
- NPI 1902773161
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718928000000",
"number": "1144865163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 SH-114 W",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "75609",
"telephone_number": "210-882-2433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRAZIER",
"first_name": "JUSTIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-11-13",
"last_updated": "2024-06-21",
"certification_date": "2024-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1321645",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Southlake, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.