Pediatric and Sports Physical Therapy PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1219370 Issued in TX

Legal business name

PEDIATRIC AND SPORTS PHYSICAL THERAPY PLLC

Practice address

211 Regency Drive
Ste 200
Wylie, TX 75098-7011

Phone

(972) 429-2187

Fax

(727) 429-2252

NPI assigned

Feb 26, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Laura Koenig, DPT

Title

Owner/Director

Phone

(972) 429-2187

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1361836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361836800000",
    "number": "1902146152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 REGENCY DR",
            "address_2": "STE 200",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750987011",
            "telephone_number": "972-429-2187",
            "fax_number": "727-429-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 REGENCY DRIVE",
            "address_2": "STE 200",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750987011",
            "telephone_number": "972-429-2187",
            "fax_number": "727-429-2252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC AND SPORTS PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-26",
        "last_updated": "2013-02-26",
        "status": "A",
        "authorized_official_last_name": "KOENIG",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "972-429-2187",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1219370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1219370",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peak Physical Therapy, LLC
• John W Pearcy, PHARMACIST
• Allen Igorovich Pearson, D.D.S
• Rayven Peck, LPC-A
• Pediatric and Sports Physical Therapy PLLC
• Pediatric Associates of Wylie, P.a.
• Personal Touch Hospice Care Inc
• Stephanie Peurifoy
• Sarah Pham
• Pickett-Me-Up Psychological Services PLLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2013; 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.