Athletico LTD
Organization Active NPI Clinic/Center · Sachse, TX
NPI 1740748136 · NPPES record last updated May 13, 2022
Key facts
- NPI
- 1740748136
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- ATHLETICO LTD
- Practice address
- 5250 Highway 78 Ste 200
Sachse, TX 75048-4253 - Phone
- (972) 244-4270
- Fax
- (972) 476-9903
- NPI assigned
- Mar 5, 2019
- Organization subpart
- No
Authorized official
- Name
- Juana Granados
- Title
- Credentialing Manager
- Phone
- (630) 575-1980
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 20
Practitioners 58
-
Shujat Ali, MSPT
-
Layne Elizabeth Ast, DPT
-
Luanne T Boyd, OT/L CHT
-
Amy Gaye Briggs, DPT
-
Adrian G Bueno, MOT, OTR
-
Kelly Clipper, DPT
-
Christian A Cook, DPT
-
Dylan G Deffebaugh, DPT
-
Grace Duininck, OT
-
Ethan Hardy Easterling, PT, DPT, ATC
-
Brooke Everard, DPT
-
Jill Toups Fawcett, P.T.
-
Cherie Gilliland, PT
-
Kristen Favre Glidden, OTR, MOT
-
Sara Gunnoe, DPT
-
Caitlin M Hartjes, DPT
-
William D Heidke, DPT
-
Matthew Hoke, PT
-
Elizabeth Jo Holland, PT, DPT
-
Ahram Hong, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190128000322 | TX | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 4789602681 |
Receives reassigned benefits from 135 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Greenville, TX; Irving, TX; Lewisville, TX; Mansfield, TX; McKinney, TX; Plano, TX; Prosper, TX; Richardson, TX… |
National Provider Directory
- Tax ID family
- Athleticoltd
Locations
14380 Marsh Ln
#120
Addison, TX 75001
Phone (972) 942-2097
230 N Denton Tap Rd
Ste 104
Coppell, TX 75019
Phone (469) 702-5972
2704 Cross Timbers Rd
Ste 90
Flower Mound, TX 75028
Phone (469) 830-9400
2552 Eldorado Pkwy
Frisco, TX 75033
Phone (469) 305-4147
3005 N Goliad St
Rockwall, TX 75087
Phone (469) 745-1935
4802 Lakeview Pkwy
Ste 101
Rowlett, TX 75088
Phone (469) 863-4203
5250 Highway 78
Ste 200
Sachse, TX 75048
Phone (972) 244-4270
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | |||
| Occupational Therapist |
225X00000X | |||
| Clinic/Center | 261Q00000X | Yes | ||
| Rehabilitation Clinic/Center | 261QR0400X |
Addresses
Primary practice location
5250 Highway 78 Ste 200
Sachse, TX 75048-4253
Mailing address
2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-1980
Other names
- Athletico Physical Therapy
Other providers in Sachse, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 13, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.