Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Addison Walter

Individual provider Physical Therapist · NPI 1265170005

Addison Walter is a Physical Therapist in Private Practice in Lewisville, Texas. Qualified in 2022, 4 years ago. Practices with Ideal Physical Therapy of Texas LLC, a 360-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
4
Licensed in
TX
In the registry since
2022
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Practice location Address checks out

1288 W Main St Ste 148
Lewisville, TX 75067-3468
Phone: (469) 496-3992
Fax: (972) 845-7419
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2920 N Stemmons Fwy, Dallas, TX 75247-6103 — (214) 630-2331

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 3128421 (TX)

Record details

NPI number1265170005
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 23, 2022
Last updated in NPPESSeptember 15, 2023
Certification dateSeptember 15, 2023
Mailing address790 Remington Blvd, Bolingbrook, IL 60440-4909

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Ideal Physical Therapy Of Texas Llc — 360 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Lewisville