Provider Demographics
NPI:1003430562
Name:PHYSIO GROUP, PLLC
Entity Type:Organization
Organization Name:PHYSIO GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHISH
Authorized Official - Middle Name:
Authorized Official - Last Name:MESEPAM
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:682-702-2562
Mailing Address - Street 1:821 SHERYN DR
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-8655
Mailing Address - Country:US
Mailing Address - Phone:682-702-2562
Mailing Address - Fax:
Practice Address - Street 1:821 SHERYN DR
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-8655
Practice Address - Country:US
Practice Address - Phone:682-702-2562
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Multi-Specialty
No2251C2600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistCardiopulmonaryGroup - Multi-Specialty
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurologyGroup - Multi-Specialty
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty