Provider Demographics
NPI:1003458555
Name:THE MOVEMENT CLINIC LLC
Entity Type:Organization
Organization Name:THE MOVEMENT CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NISHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:512-820-6998
Mailing Address - Street 1:9800 N LAKE CREEK PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78717-6072
Mailing Address - Country:US
Mailing Address - Phone:512-820-6998
Mailing Address - Fax:
Practice Address - Street 1:9800 N LAKE CREEK PKWY STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78717-6072
Practice Address - Country:US
Practice Address - Phone:512-820-6998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-16
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty