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Contact Information

EDWARD R BROAD, MPT
611 W BROWN ST
#101
WYLIE, TX75098
 Phone: 972-442-5287
 Fax: 972-442-3181
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for EDWARD R BROAD · (Male)

NPI # 1235152117
Status Active
Credentials MPT (Master of Physical Therapy)
Entity Individual
Enumeration date 07/25/2006
Last updated 01/13/2026 - About 5 months ago
Sole proprietor 1 No
Identifiers
  • TX License # 1152490
  • Other 0021MG BCBS GRP
  • Other 8T3999 BCBS IND
  • Other DD3715 MEDICARE RAILROAD GRP
  • Other P00223957 MEDICARE RAILROAD IND
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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