Crucible Physical Medicine

NPI 1154720605 - General Practice - 208D00000X

NPI Details
NPI 1154720605
Enumeration Date 08/21/2014
Last Updated 01/06/2015
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name RANDY RANDY
Position OWNER
Phone (214) 446-5300
Fax (214) 446-5304
Practice Location
6988 LEBANON RD
FRISCO TX, 75034-6735, US
Phone (214) 446-5300
Fax (214) 446-5304
Business Location
6988 LEBANON RD
SUITE 101
FRISCO TX, 75034-6735, US
Phone (214) 446-5300
Fax (214) 446-5304
Toxanomy
Taxonomy Code 208D00000X
License State Texas
License Number 40161841
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According to our database, Crucible Physical Medicine NPI is 1154720605, taxonomy code is 208D00000X and license number is 40161841, license state is located at Texas. Crucible Physical Medicine physically located at 6988 Lebanon Rd, Frisco TX, 75034-6735. NPI Number 1033115704 has the healthcare provider type.

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1154720605 NPI number is provided on an as is basis without warranty of any kind. 1154720605 is maintained by the National Plan & Provider Enumeration System. The contents of Crucible Physical Medicine are for informational purposes only.