PT2 Sports LLC

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

666340000 Issued in TX

Legal business name

PT2 SPORTS LLC

Practice address

1602 Hart St
Southlake, TX 76092

Phone

(214) 695-8847

Fax

(214) 239-0991

NPI assigned

Jul 22, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dale W Smith, PT, OCSNPI 1821102765

Title

President/Owner

Phone

(214) 695-8847

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dale Wayne Smith, PT

  • Orthopedic Physical Therapist
  • Dallas, TX
  • NPI 1821102765
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490313600000",
    "number": "1215167374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670846",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753670846",
            "telephone_number": "214-695-8847",
            "fax_number": "214-239-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 HART ST",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "76092",
            "telephone_number": "214-695-8847",
            "fax_number": "214-239-0991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PT2 SPORTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-22",
        "last_updated": "2017-03-24",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "214-695-8847",
        "authorized_official_credential": "PT, OCS"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "TX",
            "license": "666340000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF TEXAS",
            "identifier": "823T99",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Orthopedic Physical Therapist in Southlake, TX
• Providers in Southlake, TX by specialty
• Orthopedic Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.