Provider Demographics
NPI:1538354972
Name:UPTOWN PHYSICAL THERAPY
Entity type:Organization
Organization Name:UPTOWN PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:214-219-3334
Mailing Address - Street 1:4209 MCKINNEY AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-4509
Mailing Address - Country:US
Mailing Address - Phone:214-219-3334
Mailing Address - Fax:214-219-3448
Practice Address - Street 1:4209 MCKINNEY AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-4509
Practice Address - Country:US
Practice Address - Phone:214-219-3334
Practice Address - Fax:214-219-3448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1076933261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00961VOtherMEDICARE