Provider Demographics
NPI:1679544076
Name:SPEIGHT, JOHN M (PT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:SPEIGHT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5303 N MCCOLL
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504
Mailing Address - Country:US
Mailing Address - Phone:956-664-9955
Mailing Address - Fax:956-664-9957
Practice Address - Street 1:5303 N MCCOLL
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504
Practice Address - Country:US
Practice Address - Phone:956-664-9955
Practice Address - Fax:956-664-9957
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1087971225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0585036Medicaid
TX83573EMedicare ID - Type UnspecifiedPROVIDER NUMBER