Provider Demographics
NPI:1861974123
Name:ENVISION HOPE PEDIATRIC THERAPY, PLLC
Entity type:Organization
Organization Name:ENVISION HOPE PEDIATRIC THERAPY, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER & OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:BOWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-494-4677
Mailing Address - Street 1:10050 LEGACY DR STE 200
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-6752
Mailing Address - Country:US
Mailing Address - Phone:214-494-4677
Mailing Address - Fax:469-579-4090
Practice Address - Street 1:10050 LEGACY DR STE 200
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-6752
Practice Address - Country:US
Practice Address - Phone:214-494-4677
Practice Address - Fax:469-579-4090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-04
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX108438OtherEPCOTE