Source One North Plano LLC

NPI #1437906989 in Plano, Texas

Provider Information

NPI Number: 1437906989
Entity Type: Organization
Organization Name: Source One North Plano LLC
Primary Specialty: Physical Therapist
Enumeration Date: May 2, 2024
Last Updated: May 2, 2024

Practice Location

Address: 8080 INDEPENDENCE PKWY STE 110A
City: Plano
State: Texas
ZIP Code: 75025-4000
Phone: (972) 801-2190

Authorized Official

Name: WILLIAM GARRET HARRELL
Title: CHIEF OPERATIONS OFFICER
Phone: (214) 808-2724

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X
Occupational Therapist - Physical Rehabilitation — Physical Rehabilitation	225XP0019X
Psychologist - Exercise & Sports — Exercise & Sports	103TE1100X
Psychologist	103T00000X
Psychologist - Cognitive & Behavioral — Cognitive & Behavioral	103TB0200X
Psychologist - Clinical — Clinical	103TC0700X
Psychologist - Health — Health	103TH0004X
Psychologist - Intellectual & Developmental Disabilities — Intellectual & Developmental Disabilities	103TM1800X
Psychologist - Rehabilitation — Rehabilitation	103TR0400X
Physical Therapist	225100000X	Primary

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