Provider Demographics
NPI:1003863390
Name:VICTORY PHYSICAL THERAPY LIMITED PARTNERSHIP
Entity Type:Organization
Organization Name:VICTORY PHYSICAL THERAPY LIMITED PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF LEGAL AFFAIRS
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:BINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:713-297-7000
Mailing Address - Street 1:1101 S CLAY ST STE B
Mailing Address - Street 2:
Mailing Address - City:ENNIS
Mailing Address - State:TX
Mailing Address - Zip Code:75119-6422
Mailing Address - Country:US
Mailing Address - Phone:972-878-0503
Mailing Address - Fax:972-878-6219
Practice Address - Street 1:1101 S CLAY ST STE B
Practice Address - Street 2:
Practice Address - City:ENNIS
Practice Address - State:TX
Practice Address - Zip Code:75119-6422
Practice Address - Country:US
Practice Address - Phone:972-878-0503
Practice Address - Fax:972-878-6219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00W542Medicare PIN