OrganizationActive
Lake Fork Physical Therapy, PLLC
NPI 1154540540 · Physical Therapist · Emory, TX
Provider details
- NPI number
- 1154540540
- Entity type
- Organization
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Paul Bacon, Licensed Physical Therapist(903) 474-9436
- License
- 1124006 (TX)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
903 East Lennon Street
Suite 101
Emory, TX 75440
Phone: (903) 474-9436
Approximate (ZIP-level) locationGet directions
Mailing address
903 East Lennon Street
Emory, TX 75440
Registry dates
- Enumerated
- 2007-04-24
- Last updated
- 2014-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.