Edge Rehabilitation and Sports Therapy - Allen LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1139004 Issued in TX

Legal business name

EDGE REHABILITATION AND SPORTS THERAPY - ALLEN LLC

Doing business as

Edge Physical Therapy

Practice address

788 S. Watters Rd
Allen, TX 75013-4998

Phone

(469) 270-7600

Fax

(469) 270-7599

NPI assigned

Oct 7, 2016

Organization subpart

No

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

Authorized official

Name

Shane T Hernandez, DPTNPI 1437141868

Title

Owner

Phone

(972) 529-9292

Specialties & licenses 1

Addresses

Other names 1

• EDGE PHYSICAL THERAPY Doing business as

Practitioners 1

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

• Shane T Hernandez, PT

  • Physical Therapist
  • Frisco, TX
  • NPI 1437141868
  NPD (past) Authorized official

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

{
    "created_epoch": "1475798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478822400000",
    "number": "1841740347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "788 S. WATTERS RD",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750134998",
            "telephone_number": "469-270-7600",
            "fax_number": "469-270-7599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "788 S. WATTERS RD",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750134998",
            "telephone_number": "469-270-7600",
            "fax_number": "469-270-7599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGE REHABILITATION AND SPORTS THERAPY - ALLEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-07",
        "last_updated": "2016-11-11",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-529-9292",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1139004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EDGE PHYSICAL THERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amina Ebrahim, O.D.
• Echo Health Supplies LLC
• Larry Eckhardt, D.C.
• Alanah Eckrich, NP
• Eden Dental PA
• Dana Patricia Edmonds, DNP FNP-C
• David C Edwards, MD
• John Drosten Edwards Jr., MS, LPC-ASSOCIATE
• Joshua Cade Edwards, D.C.
• Paige Edwards, IBCLC

• Physical Therapist in Allen, TX
• Providers in Allen, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2016; 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.