Active NPI
Source One North Plano LLC
- Physical Therapist
- Plano, TX
National Provider Identifier
1437906989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- 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, 2024
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 DirectoryLocations
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.