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

Justin Frazier

Individual provider Physical Therapist · NPI 1144865163

Justin Frazier is a Physical Therapist in Private Practice in Southlake, Texas. Qualified in 2019, 7 years ago. Practices with Ideal Physical Therapy of Texas LLC, a 360-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
7
Licensed in
TX
In the registry since
2019
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Practice location Address may be wrong

The ZIP code does not match the city and state on this record. Call before visiting.

190 SH-114 W
Southlake, TX 75609
Phone: (210) 882-2433

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Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 1321645 (TX)

Record details

NPI number1144865163
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 13, 2019
Last updated in NPPESJune 21, 2024
Certification dateJune 21, 2024
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 2019 (7 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 Southlake