Unknown Individual – Physical Therapist, NPI 1548239197

Physical Therapist

Unknown Individual is a healthcare provider. based in Dallas, Texas. specializing in Physical Therapist. They hold a License No. 1057412 (TX). The NPI Number for Unknown Individual is 1548239197

Main info

Organization

Inactive

60 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1548239197

Phone

(972) 732-7797

Address

17817 DAVENPORT RD

Deactivation Date

28 August 2024

Doctor Profile

Medical School Name

UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL SCHOOL OF MEDICINE

Secondary Phone

9727327797

Graduation Year

1966 (60 years ago)

PAC ID

7113903352

Group Practice PAC ID

6507842747

Professional Enrollment ID

I20110114000512

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience14

Completeness75

Years active:0State licenses:1Digital endpointsOther names

Loading map...

Provider Addresses for Unknown Individual

Cakemix Recording, 17817, Davenport Road, Dallas, Collin County, Texas, 75252, United States
SUITE 230
DALLAS, TX 752525871
Phone: (972) 732-7797
Fax: (972) 732-7794
Type: Location
1400, Thames Drive, Plano, Collin County, Texas, 75075, United States
PLANO, TX 750752733
Phone: (972) 424-5072
Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 75252)

Loading plans...

Provider's Procedures

Unknown Individual performs procedures in Physical Therapist. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
PHYSICAL THERAPY	TX	97001	Physical therapy evaluation	98	97
PHYSICAL THERAPY	TX	97140	Manual (physical) therapy techniques to 1 or more regions, each 15 minutes	793	62

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 6507842747View full group profile