Source 1 Medical INC

NPI #1457016966 in Plano, Texas

Provider Information

NPI Number: 1457016966
Entity Type: Organization
Organization Name: Source 1 Medical INC
Primary Specialty: Physical Therapist
Enumeration Date: Nov 1, 2021
Last Updated: May 12, 2025

Practice Location

Address: 8080 INDEPENDENCE PKWY STE 110A
City: Plano
State: Texas
ZIP Code: 75025-4000
Phone: (469) 658-0100

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X
Occupational Therapist - Neurorehabilitation — Neurorehabilitation	225XN1300X
Occupational Therapist - Physical Rehabilitation — Physical Rehabilitation	225XP0019X
Specialist/Technologist, Other - Electroneurodiagnostic — Electroneurodiagnostic	246ZE0600X
Clinic/Center - Occupational Medicine — Occupational Medicine	261QX0100X
Psychiatry & Neurology - Neurology — Neurology	2084N0400X
Physical Therapist - Electrophysiology, Clinical — Electrophysiology, Clinical	2251E1300X
Physical Therapist - Sports — Sports	2251S0007X
Physical Therapist - Orthopedic — Orthopedic	2251X0800X
Psychiatry & Neurology - Clinical Neurophysiology — Clinical Neurophysiology	2084N0600X
Electrodiagnostic Medicine	204R00000X
Physical Therapist	225100000X	Primary

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