Organization Active NPI

Source One North Plano LLC

  • Physical Therapist
  • Plano, TX
National Provider Identifier
1437906989
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SOURCE ONE NORTH PLANO LLC
Practice address
8080 Independence Pkwy Ste 110a
Plano, TX 75025-4000
Phone
(972) 801-2190
Fax
(972) 801-2191
NPI assigned
May 2, 2024
Last updated
May 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Authorized official

Name
William Garret Harrell
Title
Chief Operations Officer
Phone
(214) 808-2724

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU
Cognitive & Behavioral Psychologist 103TB0200X NU
Clinical Psychologist 103TC0700X NU
Exercise & Sports Psychologist 103TE1100X NU
Intellectual & Developmental Disabilities Psychologist 103TM1800X NU
Rehabilitation Psychologist 103TR0400X NU
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU
Physical Rehabilitation Occupational Therapist 225XP0019X NU
Health Psychologist 103TH0004X NU

Addresses

Primary practice location

8080 Independence Pkwy Ste 110a
Plano, TX 75025-4000

Mailing address

PO Box 251728
Plano, TX 75025-1517
Phone (972) 801-2190

National Provider Directory

National Provider Directory

Locations

8080 Independence Pkwy
Ste 110A
Plano, TX 75025
Phone (469) 658-0100

NPI Registry JSON

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

{
    "created_epoch": "1714608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714608000000",
    "number": "1437906989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 251728",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750251517",
            "telephone_number": "972-801-2190",
            "fax_number": "972-801-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8080 INDEPENDENCE PKWY STE 110A",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750254000",
            "telephone_number": "972-801-2190",
            "fax_number": "972-801-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOURCE ONE NORTH PLANO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-02",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A",
        "authorized_official_last_name": "HARRELL",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "GARRET",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "214-808-2724"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TE1100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Exercise & Sports",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; 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.