Basic Information
Provider Information
NPI: 1932394558
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FOLEY
FirstName: AARON
MiddleName: PHILIP
NamePrefix: MR.
NameSuffix:  
Credential: MPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4621 W PARK BLVD
Address2: SUITE 102
City: PLANO
State: TX
PostalCode: 750932318
CountryCode: US
TelephoneNumber: 9729851776
FaxNumber: 9729856088
Practice Location
Address1: 4621 W PARK BLVD
Address2: SUITE 102
City: PLANO
State: TX
PostalCode: 750932318
CountryCode: US
TelephoneNumber: 9729851776
FaxNumber: 9729856088
Other Information
ProviderEnumerationDate: 09/06/2007
LastUpdateDate: 09/06/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X1175737TXY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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