Provider Demographics
NPI:1669136164
Name:ESSER, CORI RENEE (PT, MPT)
Entity type:Individual
Prefix:
First Name:CORI
Middle Name:RENEE
Last Name:ESSER
Suffix:
Gender:F
Credentials:PT, MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 CANO ST
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-2807
Mailing Address - Country:US
Mailing Address - Phone:571-388-8542
Mailing Address - Fax:
Practice Address - Street 1:5136 VILLAGE CREEK DR STE 502
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4460
Practice Address - Country:US
Practice Address - Phone:571-388-8542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-29
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1327226225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1327226OtherTEXAS BOARD OF PHYSICAL THERAPY