Organization · Type 2 NPI

Source 1 Medical Inc

Physical Therapist · Plano, TX

NPI number 1457016966 Active

Practice location

8080 Independence Pkwy Ste 110A
Plano, TX 75025-4000

Call (469) 658-0100 Map

Fax (469) 658-0101

Mailing address

PO Box 251728
Plano, TX 75025-1517

Other practice locations

  • 5601 Bridge St Ste 500, Fort Worth, TX 76112-2352 · (817) 457-9850
  • 5425 W Spring Creek Pkwy Ste 270, Plano, TX 75024-4317 · (972) 801-2190

Specialties and licenses

TaxonomyCodeLicense
Electrodiagnostic Medicine Physician 204R00000XNone listed
Neurology Physician 2084N0400XNone listed
Clinical Neurophysiology Physician 2084N0600XNone listed
Physical Therapist Primary 225100000XNone listed
Clinical Electrophysiology Physical Therapist 2251E1300XNone listed
Sports Physical Therapist 2251S0007XNone listed
Orthopedic Physical Therapist 2251X0800XNone listed
Occupational Therapist 225X00000XNone listed
Neurorehabilitation Occupational Therapist 225XN1300XNone listed
Physical Rehabilitation Occupational Therapist 225XP0019XNone listed
Electroneurodiagnostic Specialist/Technologist 246ZE0600XNone listed
Occupational Medicine Clinic/Center 261QX0100XNone listed

Physical Therapist: Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, r…

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About NPI 1457016966

Source 1 Medical Inc's National Provider Identifier is 1457016966, issued on Nov 1, 2021. The primary taxonomy on file is Physical Therapist (225100000X), and the practice location is in Plano, TX. The record was last updated on May 12, 2025.