Basic Information
| Provider Information | |||||||||
| NPI: | 1427583319 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PALIN | ||||||||
| FirstName: | GEORGE | ||||||||
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| Credential: | PTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 915 W EXCHANGE PKWY | ||||||||
| Address2: | STE 100 | ||||||||
| City: | ALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750137017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2145471571 | ||||||||
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| Practice Location | |||||||||
| Address1: | 915 W EXCHANGE PKWY | ||||||||
| Address2: | STE 100 | ||||||||
| City: | ALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750137017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2145471571 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/27/2017 | ||||||||
| LastUpdateDate: | 04/27/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | 2128751 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.