Active Body Active Life, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

ACTIVE BODY ACTIVE LIFE, LLC

Practice address

600 S Denton Tap Rd Ste 134
Coppell, TX 75019-4551

Phone

(214) 210-0715

NPI assigned

Feb 25, 2019

Last updated

Feb 25, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tulsi N Desai, MPT

Title

Ceo

Phone

(734) 730-4715

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1551052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551052800000",
    "number": "1619434735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 CANTERBURY CT",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750192501",
            "telephone_number": "734-730-4715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S DENTON TAP RD STE 134",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750194551",
            "telephone_number": "214-210-0715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE BODY ACTIVE LIFE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-25",
        "last_updated": "2019-02-25",
        "status": "A",
        "authorized_official_last_name": "DESAI",
        "authorized_official_first_name": "TULSI",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "734-730-4715",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Coppell, TX
• Providers in Coppell, TX by specialty
• Physical Therapy Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2019; 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.