Provider Demographics
NPI:1053550004
Name:WHITNEY, READE ERIC (ATC)
Entity type:Individual
Prefix:
First Name:READE
Middle Name:ERIC
Last Name:WHITNEY
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 FM 423
Mailing Address - Street 2:#754
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-0507
Mailing Address - Country:US
Mailing Address - Phone:813-830-8065
Mailing Address - Fax:
Practice Address - Street 1:9200 WORLD CUP WAY
Practice Address - Street 2:SUITE 202
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-4950
Practice Address - Country:US
Practice Address - Phone:813-830-8065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-16
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
TXAT57112255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer